Acute cardiac care & resuscitationCohort study

Adherence to automated external defibrillator instructions during real-life in-hospital cardiac arrest: an analysis of device data

ResuscitationPublished

  • retrospective observational study

Authors' conclusion

Adherence to core AED prompts was high, whereas interruptive and corrective instructions were disregarded more frequently. AEDs for professionals should incorporate pre-analysis countdowns or alert tones to enhance user compliance. To ensure sustained high-quality compressions, devices should provide motivational-corrective instructions and prompt timely rescuer switches.

Study context

Population
Professionals responding to in-hospital cardiac arrest with automated external defibrillators (AEDs), real AED data from a German hospital between 2007 and 2024cases analyzed among 466 AED files
Participants
419 professionals

Main finding

As reported in the abstract

Prompt adherence

Prompt adherence ranged

15.3% to 81.1%

"start CPR" followed

81.1%

"press shock button" followed

77.7%

"push harder" followed

15.3%

Observational data: associations, not effects.

Further findings

Mean chest compression (CC) depth after the "push harder" prompt

Mean CC depth increased
from 3.26 cm to 3.66 cm, 3.61 cm, 3.51 cm
  • p < 0.001

Mean CC rate · first interval

Mean CC rate improved only within the first interval
from 89.8 cpm to 102.2 cpm
  • p < 0.001

High-quality CC with adherence to "push harder"

Adherence to "push harder" associated with high-quality CC
54.6% of cases
  • p < 0.001

Original publication

Adherence to automated external defibrillator instructions during real-life in-hospital cardiac arrest: an analysis of device data. Resuscitation. Published 29 January 2026. doi:10.1016/j.resuscitation.2026.110993

Summarised from the published abstract; every number is checked against it