Abstract
Aim of the Study: The aim was to compare cardiopulmonary resuscitation (CPR) quality of an automated external defibrillator (AED) with and without additional video instruction during basic life support (BLS) by laypersons.Methods: First-year medical students were randomized either to an AED with audio only or audio with additional video instructions during CPR. Each student performed 4 min of single-rescuer chest compression only BLS on a manikin (Ambu Man C, Ballerup, Denmark) using the AED. The primary outcome was the effective compression ratio during this scenario. This combined parameter was used to evaluate the quality of chest compressions by multiplying compressions with correct depth, correct hand position, and complete decompression by flow time. Secondary outcomes were percentages of incomplete decompression and hand position, mean compression rate, time-related parameters, and subjective assessments.Results: Effective compression ratio did not differ between study groups in the overall sample (p = 0.337) or in students with (p = 0.953) or without AED experience (p = 0.278). Additional video instruction led to a higher percentage of incorrect decompressions (p = 0.014). No significant differences could be detected in time-related resuscitation parameters. An additional video was subjectively rated as more supporting (p = 0.001).Conclusions: Audio–video instructions did not significantly improve resuscitation quality in these laypersons despite that it was felt more supportive. An additional video to the verbal AED prompts might lead to cognitive overload. Therefore, future studies might target the influence of the video content and the potential benefits of video instructions in specific populations.
Highlights
Out-of-hospital cardiac arrest is among the leading causes of death in Europe [1]
Previous studies reported that the quality of cardiopulmonary resuscitation (CPR) and the time until the first shock was given by the automated external defibrillator (AED) varied significantly among different types of AEDs [9,10,11,12]
The aim of our study was to investigate the differences in CPR quality and subjective rating between AED audio– video prompts and audio prompts only
Summary
Out-of-hospital cardiac arrest is among the leading causes of death in Europe [1]. In the EMS response to a cardiac arrest, ventricular fibrillation is the initial cardiac rhythm in up to 25–50% of patients [1]. Recognition of cardiac arrest, early initiation of high-quality chest compression, and early defibrillation using an automated external defibrillator (AED) remain the cornerstone to increase patient survival [1,2,3,4]. Available AEDs offer verbal instructions on its correct use and how to perform CPR. Previous studies reported that the quality of CPR and the time until the first shock was given by the AED varied significantly among different types of AEDs [9,10,11,12]. Adaptions and evaluation of given AED instruction protocols were suggested to improve the CPR quality of the AED user [13, 14]. The addition of visual instructions to conventional AED audio commands offers a possibility to further develop AED instructions and, may improve CPR quality
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