title: Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time.
abstract: Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness.
  
  
  
  The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time.
  
  
  
  None of the AEDs was able to complete the analysis and to charge the capacitors in less than 10s and the mean post-shock pause was 6.7±2.4s. For non-shockable rhythms, the mean analysis time was 10.3±2s and the mean post-analysis time was 6.2±2.2s. We analyzed 154 AED records [104 by Emergency Medical Service (EMS) rescuers; 50 by lay rescuers]. EMS rescuers were faster in resuming CPR than lay rescuers [5.3s (95%CI 5-5.7) vs 8.6s (95%CI 7.3-10).
  
  
  
  AEDs showed different performances that may reduce CPR quality mostly for those rescuers following AED instructions. Both technological improvements and better lay rescuers training might be needed.
authors: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: s.savastano@smatteo.pv.it.
authors: Simone
authors: S
authors: Savastano
authors: SIMESO Società Italiana di Medicina del Soccorso, Italy.
authors: Vincenzo
authors: V
authors: Vanni
authors: Fondazione Ticino Cuore, Breganzona, Switzerland.
authors: Roman
authors: R
authors: Burkart
authors: AAT 118 Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Maurizio
authors: M
authors: Raimondi
authors: AAT 118 Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Fabrizio
authors: F
authors: Canevari
authors: AAT 118 Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Simone
authors: S
authors: Molinari
authors: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Enrico
authors: E
authors: Baldi
authors: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors: Aurora I
authors: AI
authors: Danza
authors: Fondazione Ticino Cuore, Breganzona, Switzerland; Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors: Maria Luce
authors: ML
authors: Caputo
authors: Anesthesiology and Intensive Care, Clinica Luganese, Lugano, Switzerland.
authors: Romano
authors: R
authors: Mauri
authors: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors: Francois
authors: F
authors: Regoli
authors: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors: Giulio
authors: G
authors: Conte
authors: Fondazione Ticino Cuore, Breganzona, Switzerland.
authors: Claudio
authors: C
authors: Benvenuti
authors: Fondazione Ticino Cuore, Breganzona, Switzerland; Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors: Angelo
authors: A
authors: Auricchio
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods / Q000592:standards; D003198:Computer Simulation; D047548:Defibrillators / Q000145:classification / Q000592:standards; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards; D005392:First Aid / Q000295:instrumentation / Q000379:methods / Q000592:standards; D006801:Humans; D007558:Italy; D008348:Manikins; D008422:Materials Testing; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D013647:Task Performance and Analysis; D013997:Time Factors; D061665:Time-to-Treatment
keywords: AED; CPR; Hands-off time; Resuscitation