Usability of Automated External Defibrillators by untrained Bystanders in a Simulated Cardiac Arrest Scenario

Usability of Automated External Defibrillators by untrained Bystanders in a Simulated Cardiac Arrest Scenario | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Usability of Automated External Defibrillators by untrained Bystanders in a Simulated Cardiac Arrest Scenario Ruican Zhong, Meg Moldestad, Ayumi Oishi, Neha Ramana, Pooja Tekade, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8746954/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Public Access Automated External Defibrillators (AEDs) are intended for use by laypersons during out–of-hospital cardiac arrest, yet bystander use remains limited. Usability differences between devices may influence AED deployment in emergency situations. Methods A randomized comparative simulation study evaluated four commercially available AEDs used by untrained participants in a standardized adult cardiac arrest scenario. Objective task performance measures and subjective usability ratings were collected and analyzed using one-way ANOVA with post-hoc testing. Results Significant differences were observed across devices, particularly during pad placement, shock delivery, and initiation of cardiopulmonary resuscitation (p < 0.0001). Devices providing clearer visual and verbal instructions were associated with faster task completion, higher accuracy, and greater user confidence. Conclusions AED usability varies substantially across devices. Human factors-driven design features that reduce cognitive load may improve bystander AED use in emergency settings. Trial registrations: not applicable Automated External Defibrillator out-of-hospital cardiac arrest bystander intervention emergency medical device public-access defibrillation cardiopulmonary resuscitation lay responder. Full Text Additional Declarations Competing interest reported. B.A., D.J. and the paramedic who performed the pad placement assessment are employees of Heartstream US LLC (formerly Philips Emergency Care), a manufacturer of one of the devices. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8746954","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":588357719,"identity":"2c68f344-7265-4d90-9fd6-d1e99f6dd994","order_by":0,"name":"Ruican Zhong","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuElEQVRIiWNgGAWjYFACHhBhI8cP5rARryXNWLKBRC2HEzccIFaLef/Zg48Lfh02Nr6RY8DwoewwYS0yB84lG8/sS5czA2phnHGOCC0SjD1m0rw91sZmN3I3MPO2EaOFmQekhTlx8wyglr9EaWEDauH54Zy4QQKohZEoLTw8xsa8DWnGEmfefzjYcy6dCC38Zwwf8/wBRmV7WuKDH2XWhLWAAWMbhD5ApHoQ+EOC2lEwCkbBKBh5AACQWzcc9rf0NwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Washington","correspondingAuthor":true,"prefix":"","firstName":"Ruican","middleName":"","lastName":"Zhong","suffix":""},{"id":588357721,"identity":"096f9ae5-e250-49e3-b216-cf02b384e382","order_by":1,"name":"Meg Moldestad","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Meg","middleName":"","lastName":"Moldestad","suffix":""},{"id":588357722,"identity":"0b52357c-713f-487b-9e80-b000d8fd48b7","order_by":2,"name":"Ayumi Oishi","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Ayumi","middleName":"","lastName":"Oishi","suffix":""},{"id":588357723,"identity":"0eb54795-b8bb-43a4-87f8-45d795273e09","order_by":3,"name":"Neha Ramana","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Neha","middleName":"","lastName":"Ramana","suffix":""},{"id":588357724,"identity":"66ad8a39-c630-4a28-af0a-bb209bdfe03a","order_by":4,"name":"Pooja Tekade","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Pooja","middleName":"","lastName":"Tekade","suffix":""},{"id":588357725,"identity":"477395d0-6f90-4d37-ac9e-950dd1d91faf","order_by":5,"name":"Celia Tsao","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Celia","middleName":"","lastName":"Tsao","suffix":""},{"id":588357728,"identity":"7e0c9f77-6837-4055-964f-5c498c79d748","order_by":6,"name":"Clarice Wu","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Clarice","middleName":"","lastName":"Wu","suffix":""},{"id":588357729,"identity":"fe2d8a71-d5b6-4445-8692-8556d53a3c7d","order_by":7,"name":"Siyu Wang","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Siyu","middleName":"","lastName":"Wang","suffix":""},{"id":588357730,"identity":"76be881f-fe43-480d-ab60-1bde19fb4870","order_by":8,"name":"Brian Arbanas","email":"","orcid":"","institution":"Heartstream US LLC (formerly Philips)","correspondingAuthor":false,"prefix":"","firstName":"Brian","middleName":"","lastName":"Arbanas","suffix":""},{"id":588357731,"identity":"26f0c3f1-cbc5-4c92-b641-ca3c31ed9502","order_by":9,"name":"Dawn Jorgenson","email":"","orcid":"","institution":"Heartstream US LLC (formerly Philips)","correspondingAuthor":false,"prefix":"","firstName":"Dawn","middleName":"","lastName":"Jorgenson","suffix":""},{"id":588357732,"identity":"1aef9fa3-c002-48df-9bd5-525eb6285cd5","order_by":10,"name":"Beth Kolko","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Beth","middleName":"","lastName":"Kolko","suffix":""},{"id":588357733,"identity":"efd28437-43e1-4c15-aba4-ab6c219a9e1a","order_by":11,"name":"Gary Hsieh","email":"","orcid":"","institution":"University of Washington","correspondingAuthor":false,"prefix":"","firstName":"Gary","middleName":"","lastName":"Hsieh","suffix":""}],"badges":[],"createdAt":"2026-01-31 06:10:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8746954/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8746954/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106847365,"identity":"aee23d31-bde5-47a8-bd13-2215ac2132a0","added_by":"auto","created_at":"2026-04-14 05:26:16","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1046165,"visible":true,"origin":"","legend":"","description":"","filename":"1AEDsubmission0125.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8746954/v1_covered_f5c7a058-da59-4def-b902-17c8b9d8aed0.pdf"}],"financialInterests":"Competing interest reported. B.A., D.J. and the paramedic who performed the pad placement assessment are employees of Heartstream US LLC (formerly Philips Emergency Care), a manufacturer of one of the devices.","formattedTitle":"Usability of Automated External Defibrillators by untrained Bystanders in a Simulated Cardiac Arrest Scenario","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Automated External Defibrillator, out-of-hospital cardiac arrest, bystander intervention, emergency medical device, public-access defibrillation, cardiopulmonary resuscitation, lay responder.","lastPublishedDoi":"10.21203/rs.3.rs-8746954/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8746954/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePublic Access Automated External Defibrillators (AEDs) are intended for use by laypersons during out–of-hospital cardiac arrest, yet bystander use remains limited. Usability differences between devices may influence AED deployment in emergency situations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA randomized comparative simulation study evaluated four commercially available AEDs used by untrained participants in a standardized adult cardiac arrest scenario. Objective task performance measures and subjective usability ratings were collected and analyzed using one-way ANOVA with post-hoc testing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSignificant differences were observed across devices, particularly during pad placement, shock delivery, and initiation of cardiopulmonary resuscitation (p \u0026lt; 0.0001). Devices providing clearer visual and verbal instructions were associated with faster task completion, higher accuracy, and greater user confidence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAED usability varies substantially across devices. Human factors-driven design features that reduce cognitive load may improve bystander AED use in emergency settings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registrations: \u003c/strong\u003e\u003cem\u003enot applicable\u003c/em\u003e\u003c/p\u003e","manuscriptTitle":"Usability of Automated External Defibrillators by untrained Bystanders in a Simulated Cardiac Arrest Scenario","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-11 18:33:48","doi":"10.21203/rs.3.rs-8746954/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"47492c8a-1920-45cd-8481-9d068981c4ce","owner":[],"postedDate":"February 11th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-14T05:25:52+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-11 18:33:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8746954","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8746954","identity":"rs-8746954","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}