Purpose:
According to 2021 ERC Guidelines, Basic Life Support (BLS) should focus on chest compressions with a minimal No-Flow Fraction (NFF), early defibrillation, and a short perishock pause. By using an automated external defibrillator (AED), users are guided through the process of attaching electrodes and initiating defibrillation.
This study tested theimpact of usability optimized AED on the interruption of chest compressions during BLS when an AED is used by untrained or minimally trained rescuers.
Methods:
Based on SJTREM published study comparing 8 commercialized AEDs, the AED with the best delivered BLS quality was used in this study. This AED was submitted to usability optimizations related to the sequencing of human device interactions, the user interfaces (voice prompts, Graphical User Interfaces) as well as the device and accessories´ conception (shape, color and positioning).
Using a patient simulator, a group of 64 untrained laymen acted as rescuers in a simulated office environment and followed the voice prompt of the two versions of the AED (original and optimized). In the two scenarios, the NFF was evaluated.
Results:
Using the original AED, the mean NFF (from the time of AED use) was 0,67 (SD 0,07). With the usability-optimized AED, it reached 0,50 (SD 0,15). The results were compared using paired z-test and considered statistically significant at p-value <0.01.
Conclusions:
The heterogeneity of AED devices (i.e. human-device interactions, device conception) can be misleading for lay users. Thus, usability of AED should be considered parallel to BLS training as key elements in order to push towards optimizing the medical parameters.
This study suggests standardizing Human-Machine Interfaces (HMI) of AED by a referenced organization and defining common usability guidelines that should be respected by all AED manufacturers.
In a broader context, combining training with standardized HMI AEDs can be a pedagogical plus resulting in better medical outcomes.

Effects of AED usability optimization on the no-flow fraction during cardiac resuscitation initiated by layman (BLS). A usability study for automated external defibrillators

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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