Skip to main content

Effects and limitations of an automated external defibrillator with audiovisual feedback for cardiopulmonary resuscitation: a randomized manikin study


Correctly performed basic life support (BLS) and early defibrillation are the most effective measures to treat sudden cardiac arrest. Audiovisual feedback improves BLS. Automated external defibrillators (AEDs) with feedback technology may play an important role in improving CPR quality. The aim of this simulation study was to investigate whether an AED with audiovisual feedback improves CPR parameters during standard BLS performed by trained laypersons.


With ethics committee approval and informed consent, 68 teams (two flight attendants each) performed 12 minutes of standard CPR with the AED's audiovisual feedback mechanism enabled or disabled. We recorded CPR quality parameters during resuscitation on a manikin in this open, prospective, randomized controlled trial. Between the feedback and control group we measured differences in compression depth and rate as the main outcome parameters and effective compressions, correct hand position, and incomplete decompression as secondary outcome parameters. An effective compression was defined as a compression with correct depth, hand position, and decompression.


The feedback group delivered compression rates closest to the recommended guidelines (101 ± 9 vs. 109 ± 15/minute, P = 0.009), more effective compressions (20 ± 18 vs. 5 ± 6%, P < 0.001), more compressions with correct hand position (96 ± 13 vs. 88 ± 16%, P < 0.001), and less leaning (21 ± 31 vs. 77 ± 33%, P < 0.001). However, only the control group adhered to the recommended compression depth (44 ± 7 mm vs. 39 ± 6, P = 0.003).


Use of an AED's audiovisual feedback system improved some CPR quality parameters, thus confirming findings of earlier studies, with the notable exception of decreased compression depth, which is a key parameter that might be linked to reduced cardiac output.

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Fischer, H., Gruber, J., Neuhold, S. et al. Effects and limitations of an automated external defibrillator with audiovisual feedback for cardiopulmonary resuscitation: a randomized manikin study. Crit Care 15 (Suppl 1), P296 (2011).

Download citation

  • Published:

  • DOI:


  • Sudden Cardiac Arrest
  • Basic Life Support
  • Automate External Defibrillator
  • Feedback Group
  • Flight Attendant