A study comparing the usability of fully automatic versus semi-automatic defibrillation by untrained nursing students

Area of Science:

• Cardiovascular Medicine
• Emergency Medicine
• Medical Device Usability

Background:

• International guidelines currently favor semi-automatic external defibrillators (SAEDs) over fully automatic external defibrillators (FAEDs).
• Evidence supporting this guideline preference is limited.
• This study addresses the lack of comparative usability data between FAED and SAED devices.

Purpose of the Study:

• To compare the usability of a fully automatic external defibrillator (FAED) versus a semi-automatic external defibrillator (SAED).
• To evaluate the impact of FAED use on rescuer compliance, safety, and speed in a simulated cardiac arrest scenario.
• To test the hypothesis that FAED use minimizes operator-device interactions.

Main Methods:

• Sixty-two untrained first-year nursing students were randomized to use either the FAED or SAED version of the Lifepak CR Plus AED.
• Participants performed in a simulated cardiac arrest scenario with device-guided voice prompts.
• Performance was assessed for efficacy and safety via video recording.

Main Results:

• FAED users committed significantly fewer errors during rhythm analysis (8% vs. 17%) and shock delivery (0% vs. 7%) compared to SAED users.
• FAED use reduced variability in the time interval between the first and third shock delivery.
• The majority of students, despite lacking prior training, demonstrated safe and effective AED use.

Conclusions:

• The fully automatic external defibrillator (FAED) version of the CR Plus AED enhances protocol compliance and reduces time variability for shock delivery.
• FAEDs show potential for improved usability and effectiveness in lay rescuer scenarios.
• Further research is recommended to validate these findings across diverse first responder groups.