Comparison of ease of use of three automated external defibrillators by untrained lay people

The use of automated external defibrillators (AED) by lay people has the potential to markedly increase survival from community cardiac arrest. Wider public use of AEDs requires units that can be operated safely and effectively by people with minimal or no training. This study compares the use of three AEDs by untrained lay people regarding ease-of-use, safety, pad positioning and time to defibrillation. 24 subjects with no prior exposure to the use of AEDs were asked to perform simulated defibrillation on a manikin using three defibrillators: Zoll AEDPlus, Medtronic Physio-Control LifePak CR Plus and Philips/Laerdal HeartStart OnSite Defibrillator. Subjects' performance were videotaped and reviewed for time to defibrillate, pad positioning and safety. Subjects were asked to rate the three units in terms of ease-of-use. Average times to first shock were 74.8 s for the Physio-Control, 83.0 s for the Laerdal and 153.4 s for the Zoll defibrillator. Pad positioning was scored as correct in 23/24 Laerdal trials, 19/24 Physio-Control trials and 14/24 Zoll trials. 23 out of the 24 subjects rated the Zoll most difficult to use. All subjects safely stayed clear of the unit when required. The majority of subjects safely and effectively delivered defibrillating shocks without any prior training and within quite acceptable times. Untrained subjects find the Physio-Control and Laerdal Defibrillator easier to use than the Zoll device. Features of AED design that improved ease of use are discussed.