The Presence of Warning Labels on AEDs Decreases the Odds of Device Use by Lay Rescuers

Introduction—Significant resources have been invested in public access defibrillation programs; however, the true rate of lay rescuer AED use remains unknown. Even in circumstances where the device location is known, numerous potential barriers to lay rescuer use remain. Among these is the presence of warning labels (e.g., Trained Responders Only), which might induce anxiety and reinforce a state of low self-efficacy. The purpose of this study was to determine if the presence of warning labels on or near public access defibrillators influences lay rescuer self-reported willingness to utilize such devices in an emergency scenario.

Methods—This prospective cross-sectional survey study utilized a simple random sample of adults age 18–65. Healthcare providers were excluded. Participants were asked a series of questions regarding their past experiences with CPR/AED training and were then shown a static picture of an AED. Two versions of the picture were alternated between participants in a random fashion, with half of participants seeing a warning label on the device. Participants were asked about their willingness to utilize the device if faced with a victim of cardiac arrest. Comparisons were made between participants in the two groups to determine the potential influence of warning labels on self-reported willingness to render aid. Reported past experience and demographics (e.g., age, gender, income, education, etc.) were used for control purposes.

Results—The majority of participants (71%, n=500) indicated a willingness to assist, but fewer participants were willing to assist when presented with a warning label (65%) than when no such label was present (75%). The odds of lay rescuer AED use were significantly decreased in the presence of a warning label (OR 0.51, 95% CI: 0.34–0.75).

Conclusion—The presence of a warning label on an AED decreased the odds of device use by lay rescuers, but it is unknown if actual human performance would be consistent with such responses in the face of an actual emergency.