Is there any room for shortening hands-off time further when using an AED?

Abstract

Automated external defibrillators (AEDs) play a very important role in out-of-hospital cardiopulmonary resuscitation (CPR). The mandatory hands-off time imposed by current AEDs is not short enough to bring about the full benefits of rapid defibrillation with an AED into light. The aim of this study is to examine whether a change in the process of charging the capacity and removing explanations from the prompts of the AEDs shortens hands-off time. The operating steps and the voice prompts of the current AEDs were reviewed and the time intervals between the steps and the voice prompts were measured. We modified an AED to fully precharge the capacitor and to contain more concise voice prompts. We had 42 expert rescuers and 50 lay-person rescuers perform 2-rescuer CPR with the modified AED and the old AED, respectively. Using the modified AED significantly reduced hands-off times by 9.95 s (95% CI: 9.67-10.23) in 2-rescuer CPR and by 10.68 s (95% CI: 9.75-11.61) in 1-rescuer CPR (p<0.001). Full precharging of the capacitor and exclusion of explanations from the voice prompts of AEDs can shorten the hands-off time in both 1 and 2-rescuer CPR.