METHODS: From June 1, 2018, to November 30, 2019, a prospective longitudinal randomized controlled simulation study was conducted among 165 laypeople (18-65 years old) without prior AED training. A self-instruction card was designed to illuminate key AED operation procedures. Subjects were randomly divided into the card (n=83) and control (n=82) groups with age stratification. They were then individually evaluated in the same simulated scenario to use AED with (card group) or without the self-instruction card (control group) at baseline, post-training, and at the 3-month follow-up.
RESULTS: At baseline, the card group reached a significantly higher proportion of successful defibrillation (31.1% vs. 15.9%, P=0.03), fully baring the chest (88.9% vs. 63.4%, P<0.001), correct electrode placement (32.5% vs. 17.1%, P=0.03), and resuming cardiopulmonary resuscitation (CPR) (72.3% vs. 9.8%, P<0.001). At post-training and follow-up, there were no significant differences in key behaviors, except for resuming CPR. Time to shock and time to resume CPR were shorter in the card group, while time to power-on AED was not different in each phase of tests. In the 55-65 years group, the card group achieved more skill improvements over the control group compared to the other age groups.
CONCLUSIONS: The self-instruction card could serve as a direction for first-time AED users and as a reminder for trained subjects. This could be a practical, cost-effective way to improve the AED skills of potential rescue providers among different age groups, including seniors.
方法:从2018年6月1日至2019年11月30日,在未经AED培训的165名外行人(18-65岁)中进行了一项前瞻性纵向随机对照模拟研究。设计了一个自我指导卡,以照亮关键的AED操作程序。根据年龄分层,将受试者随机分为卡片组(n=83)和对照组(n=82)。然后在相同的模拟场景中对他们进行单独评估,以在基线时使用有(卡组)或没有自我指导卡(对照组)的AED,培训后,在3个月的随访中。
结果:在基线时,卡组除颤成功的比例明显更高(31.1%vs.15.9%,P=0.03),完全露出胸部(88.9%vs.63.4%,P<0.001),正确的电极放置(32.5%与17.1%,P=0.03),并恢复心肺复苏(CPR)(72.3%vs.9.8%,P<0.001)。在培训后和后续行动中,关键行为没有显着差异,除了恢复心肺复苏术。卡组的休克时间和恢复心肺复苏的时间较短,而AED的通电时间在每个测试阶段都没有差异。在55-65岁组中,与其他年龄组相比,卡组比对照组获得了更多的技能改善。
结论:自我指导卡可以作为首次AED用户的指导,也可以作为受过训练的受试者的提醒。这可能是一个实际的,以具有成本效益的方式提高不同年龄段潜在救援提供者的AED技能,包括老年人。