From the Department of Epidemiology (A.M.J., B.M.D., E.W., W.D.R.), Gillings School of Global Public Health; School of Medicine (C.J.C., F.O.); School of Nursing (J.K.Z.-H.); and North Carolina Translational and Clinical Sciences Institute (M.E.G.), University of North Carolina at Chapel Hill, Chapel Hill, NC.
Simul Healthc. 2022 Feb 1;17(1):22-28. doi: 10.1097/SIH.0000000000000582.
Probability of survival after out-of-hospital cardiac arrest (OHCA) doubles when a bystander initiates cardiopulmonary resuscitation and uses an automated external defibrillator (AED) rapidly. National, state, and community efforts have increased placement of AEDs in public spaces; however, bystander AED use remains less than 2% in the United States. Little is known about the effect of giving bystanders directional assistance to the closest public access AED.
We conducted 35 OHCA simulations using a life-sized manikin with participants aged 18 through 65 years who searched for public access AEDs in 5 zones on a university campus. Zones varied by challenges to pedestrian AED acquisition and number of fixed AEDs. Participants completed 2 searches-first unassisted and then with verbal direction to the closest AED-and we compared AED delivery times. We conducted pretest and posttest surveys.
In all 5 zones, the median time from simulated OHCA onset to AED delivery was lower when the bystander received directional assistance. Time savings (minutes:seconds) varied by zone, ranging from a median of 0:53 (P = 0.14) to 3:42 (P = 0.02). Only 3 participants immediately located the closest AED without directional assistance; more than half reported difficulty locating an AED.
These findings may inform strategies to ensure that AEDs are consistently marked and placed in visible, accessible locations. Continued emphasis on developing strategies to improve lay bystanders' ability to locate and use AEDs may improve AED retrieval times and OHCA outcomes.
院外心脏骤停（OHCA）患者的生存率在旁观者进行心肺复苏并迅速使用自动体外除颤器（AED）时增加一倍。国家、州和社区已经努力在公共场所增加 AED 的配置；然而，旁观者使用 AED 的比例仍低于美国的 2%。对于向最近的公共获取 AED 为旁观者提供定向协助的效果知之甚少。
我们使用真人大小的人体模型进行了 35 次 OHCA 模拟，参与者年龄在 18 至 65 岁之间，他们在大学校园的 5 个区域中寻找公共获取的 AED。区域的设置因行人获取 AED 的挑战和固定 AED 的数量而异。参与者完成了 2 次搜索——第一次是无辅助的，然后是接受到最近的 AED 的口头指示——我们比较了 AED 送达时间。我们进行了预测试和后测试调查。
在所有 5 个区域中，当旁观者接受定向协助时，从模拟 OHCA 发作到 AED 送达的中位数时间较低。节省的时间（分钟：秒）因区域而异，范围从中位数 0:53（P = 0.14）到 3:42（P = 0.02）。只有 3 名参与者在没有定向协助的情况下立即找到最近的 AED；超过一半的人报告说找到 AED 有困难。
这些发现可能为确保 AED 始终标记并放置在可见、易于访问的位置提供策略信息。继续强调制定策略以提高急救人员定位和使用 AED 的能力，可能会提高 AED 检索时间和 OHCA 结果。
