A Narrative Literature Review and Case Study Highlighting Errors in Automatic External Defibrillator Use at a...

Early basic life support and defibrillation using automated external defibrillators (AEDs) are key for improving survival in those suffering an out-of-hospital sudden cardiac arrest. To improve survival, access to AEDs by lay responders is growing, and use is included in basic cardiac life support training. These devices are considered extremely safe, evidenced by the paucity of medical literature on AED misuse and expert opinion. However, it's crucial to point out that even medical personnel can make errors in their use. This case study of AED misuse during a community event and narrative literature review underscores the potential for errors in using an AED, which could cause considerable patient harm. To prevent errors in AED use, it is important to train on (1) equipment in use or likely to be encountered in the field, (2) how to dump an electric charge, especially when using a fully automated machine, (3) the need to follow specific machine instructions, (4) proper application of the defibrillator pads (including one-piece pads with metronome), (5) the need to assess the patient and not rely entirely on the AED prompts, which can contain false alerts and inappropriate instruction, and (6) the need for closed-loop communication, even when participating in a community event.