Introduction: Defibrillation with an automated external defibrillator (AED) improves survival after cardiac arrest. Laypersons rarely place the left apical AED electrodes according to international guidelines. Incorrect electrode placement may reduce the chance of successful defibrillation.
Hypothesis: Novel AED electrodes with pictures of correct electrode placement on a human improves left apical AED electrode placement compared with conventional AED electrodes with standard pictograms.
Methods: Untrained laypersons were randomized to apply A) Novel AED electrodes with pictures of correct electrode placement on a human (Figure), or B) conventional AED electrodes with pictograms on a resuscitation manikin. Positioning of AED electrodes was compared to the recommended electrode position. Time to AED electrode placement was measured. Participants were asked to rate the user-friendliness of the two electrode designs on a 10 point-scale. The primary endpoint was ratio of correct left apical AED electrode placement defined as ≤5 cm from the recommended position.
Results: In total, 84 participants were randomized to novel (n=39, female: 62% median age: 41.5 years (±10.3)) and standard (n=45, female: 64% median age: 43.5 (±8.2)) electrodes. The left apical AED electrode placement was improved when using novel electrodes with pictures compared with standard electrodes (51% vs 18%, (P<0.0001). No significant difference in right AED electrode placement was observed. Time to AED electrode placement was faster using novel electrodes with pictures (difference: 7.9 sec, P<0.0001). User-friendliness was rated higher in novel AED electrodes with pictures compared to conventional electrodes (9 (8;10) vs. 7 (6;8)) (P=0.001).
Conclusion: A novel AED electrode design with pictures results in faster and better electrode placement compared with conventional AED electrodes using standard pictograms. Novel electrodes with pictures were preferred by laypersons.