Slightly less than half (47 percent) of the people in a public place with access to an automated external defibrillator (AED) would be willing to use it, with slightly more than half (53 percent) unable even to recognize one, according to a study published online Feb. 3 in the Annals of Emergency Medicine.
In addition, 43 percent of participants in the study said they would not use the device, while 10 percent were uncertain.
"An AED is only beneficial if a bystander is willing to use it when someone is in cardiac arrest," said lead study author Patrick Schober, MD, PhD, of VU University Medical Center in Amsterdam, the Netherlands. "AEDs are increasingly available in public places, such as the train station where we conducted our survey. However, in our study, only 28 percent of participants correctly identified the AED, knew its purpose and expressed a willingness to use it."
Schober and colleagues surveyed 1,018 people in the Central Railway Station of Amsterdam, "a highly frequented and AED-equipped public place with a high number of travelers and visitors from all over the world."
When specifically interrogated, 64 percent knew what a defibrillator is used for; however, just over one-third (34 percent) of participants stated that anyone is allowed to use an AED, with nearly half (49 percent) believing only trained personnel may use it. The most frequently mentioned reason given for not using an AED was not knowing how it works (69 percent), followed by fear of harming the victim (14 percent).
Only 6 percent of study participants spontaneously mentioned AEDs in response to a question about what should be done as quickly as possible for someone suspected of being in cardiac arrest. More than two-thirds (67 percent) indicated they would "call for help," while 20 percent said chest compressions should be given.
"To be actually able to use an AED, several requirements must be met simultaneously," researchers said. "The potential rescuer not only has to know that defibrillation may be required, but also must know that AEDs are available for public use, must be able to identify an AED on site, and must be willing to use it."
While the study was not powered to detect differences in knowledge between subgroups, some observed trends include:
- Women were more often unwilling to use an AED;
- Participants younger than 25 years and older than 60 years exhibited less knowledge and less willingness to operate an AED than middle-aged participants; and
- North Americans more often correctly identified the AED, knew its purpose and stated that they would use it.
"These differences, if confirmed by further studies, can be helpful to better tailor public access defibrillation campaigns to specific target audiences," researchers wrote.
"AEDs are actually very easy to use, but it is obvious that the public has not gotten that message," Schober said. "Only a minority of individuals demonstrated both knowledge and willingness to operate an AED. Wide-scale public information campaigns are an important next step to exploit the lifesavings potential of public AEDs."
As many participants indicated they would not use the device because they don't know how or because they fear the devices could cause harm to the person in arrest, one such public information campaign should emphasize the ease and safety of AED use, according to the study.
"We are not aware of a single report about inadvertent AED-related injury of any individual," the authors wrote.
The authors also noted that public information campaigns should address legal aspects of device use, as most countries allow laypeople to use AEDs without having to fear legal consequences or liability. Yet, almost half of the people surveyed believed that only trained personnel were allowed to operate AEDs.