18 How do public attitudes to automated external defibrillators affect their use in out-of-hospital cardiac arrest?

INTRODUCTION: Sudden cardiac death is one of the leading causes of mortality in the UK. The incidence of out-of-hospital cardiac arrest (OHCA) in the UK is approximately 30 000. The initial cardiac rhythm in these cases is often a ventricular tachyarrhythmia which requires electrical defibrillation. The efficacy of defibrillation is dependent on its timely use, with the odds of survival decreasing by up to 10% for every minute of delay. The use of AEDs has been shown to significantly improve neurologically intact survival in OHCA. Significant progress has been made regarding the provision of AEDs in public places but it is questioned whether sufficient public education has been undertaken in order to support this strategy. This study aims to explore the attitudes of the general public in order to inform public education strategies, increase AED use and ultimately improve survival of OHCA.

METHODS: A questionnaire was devised and presented to a convenience sample of adult patients and their relatives presenting to the Emergency Department Urgent Care Centre at University Hospital Lewisham over a 3 month period from January-March 2017. Participants were asked about their age, educational background, previous resuscitation training and knowledge of AED. Those with correct knowledge of AEDs were also asked about their willingness to operate one and to give reasons if reluctant to use an AED in an OHCA.Institutional ethical approval was obtained.

RESULTS: A total of 216 responses were obtained. 12 were excluded in the analysis as the questionnaires were not fully complete and thus 204 were included in the final data analysis. 32% of the study participants reported knowing about AEDs but only 23% correctly described its use. 19% of the study participants had both accurate knowledge and a willingness to operate an AED. 66% of those correctly describing AEDs and willing to use them had some form of resuscitation training. 6% of the study sample had no resuscitation training but correctly described AEDs and were willing to operate one.Common reasons for unwillingness to operate AEDs were fear of causing more harm, fear of doing it incorrectly, perceived danger of the equipment and lack of training.

CONCLUSION: The level of knowledge of AEDs is low amongst the general public. Majority of the study population who knew about AEDs had some degree of resuscitation training. Further research is required to ascertain how to translate knowledge into optimal use of AEDs in practice.