Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time

Resuscitation. 2017 Jan:110:12-17. doi: 10.1016/j.resuscitation.2016.10.006. Epub 2016 Oct 22.

Abstract

Purpose: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness.

Methods: The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time.

Results: None of the AEDs was able to complete the analysis and to charge the capacitors in less than 10s and the mean post-shock pause was 6.7±2.4s. For non-shockable rhythms, the mean analysis time was 10.3±2s and the mean post-analysis time was 6.2±2.2s. We analyzed 154 AED records [104 by Emergency Medical Service (EMS) rescuers; 50 by lay rescuers]. EMS rescuers were faster in resuming CPR than lay rescuers [5.3s (95%CI 5-5.7) vs 8.6s (95%CI 7.3-10).

Conclusions: AEDs showed different performances that may reduce CPR quality mostly for those rescuers following AED instructions. Both technological improvements and better lay rescuers training might be needed.

Keywords: AED; CPR; Hands-off time; Resuscitation.

MeSH terms

  • Cardiopulmonary Resuscitation* / instrumentation
  • Cardiopulmonary Resuscitation* / methods
  • Cardiopulmonary Resuscitation* / standards
  • Computer Simulation
  • Defibrillators* / classification
  • Defibrillators* / standards
  • Electric Countershock* / instrumentation
  • Electric Countershock* / methods
  • Emergency Medical Services* / methods
  • Emergency Medical Services* / standards
  • First Aid* / instrumentation
  • First Aid* / methods
  • First Aid* / standards
  • Humans
  • Italy
  • Manikins
  • Materials Testing
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Task Performance and Analysis
  • Time Factors
  • Time-to-Treatment