Variability of Automated External Defibrillator Signage Across Six Continents
Abstract Body: Introduction/Background Despite evidence supporting their efficacy in improving out-of-hospital cardiac arrest survival, public utilization of automated external defibrillators (AEDs) remains low. Characteristics of AED signage varies considerably, despite international standards developed by the International Liaison Committee on Resuscitation (ILCOR). The extent of this variability, which may lead to confusion and reduced AED use, is unknown.
Research Questions/Hypothesis We hypothesize that there is variability in AED signage globally.
Goals/Aims We aimed to describe variability of AED signage across six continents, focusing on shape, color, and the presence of heart, cross, electric bolt, and arrow symbols.
Methods/Approach We reviewed a convenience sample of publicly available AED signage found online from countries in Europe, North American, Africa, Australia, Asia, and South America. We used internet search terms such as “AED,” “AED sign,” “AED signage,” “Defibrillator sign,” “Defibrillator signage,” followed by the country name. Characteristics including shape, color, and the presence of cross, heart, electric bolt, and arrow symbols were recorded in a data collection form. We reported frequencies and proportions of these characteristics for the entire sample and stratified by continent. Fisher's exact tests were used to compare proportions across continents. Statistical significance was set at p<0.05.
Results/Data Between December 2024 and May 2025, 142 AED signage images were collected. After excluding 22 images depicting actual AEDs or carrying cases, 120 images were analyzed. Continents included Europe (46 images, 38.3%), North America (28, 23.3%), Africa (17, 14.2%), Australia (15, 12.5%), Asia (9, 7.5%), and South America (5, 4.2%). Most signs were rectangular (81.7%), had a green background (43.3%), white text (48.3%), and included symbols of a cross (43.3%), heart (98.3%), and electric bolt (91.7%). Of the signs displaying a cross (52), 86.5% were white. Of those with a heart (118), 52.5% were white. Of those with an electric bolt (110), 44.6% were green. Only 33.3% of signs included an arrow. The distribution of all signage characteristics varied significantly across the six continents (all p<0.05).
Conclusions We found variability in AED signage characteristics, with significant differences in shapes, colors, and images. Further studies may investigate whether signage characteristics are associated with improved AED recognition and use.
Karamcheti, Sanjana
( UC San Diego School of Medicine
, San Diego
, California
, United States
)
Li, Timmy
( Northwell Health
, Manhasset
, New York
, United States
)
Bey, Christian
( UC San Diego School of Medicine
, San Diego
, California
, United States
)
Marble, Blake
( University of Washington School of Medicine
, Seattle
, Washington
, United States
)
Marill, Keith
( Massachusetts General Hospital
, Boston
, Massachusetts
, United States
)
Donofrio-odmann, Joelle
( University of California San Diego, School of Medicine
, San Diego
, California
, United States
)
Rittenberger, Jon
( Robert Packer Hospital, The Guthrie Clinic
, Sayre
, Pennsylvania
, United States
)
Cabanas, Jose
( University of North Carolina at Chapel Hill
, Chapel Hill
, North Carolina
, United States
)
Jameson, Angus
( University of South Florida
, Largo
, Florida
, United States
)
Author Disclosures:
Sanjana Karamcheti:DO NOT have relevant financial relationships
| Timmy Li:DO NOT have relevant financial relationships
| Christian Bey:No Answer
| Blake Marble:No Answer
| Keith Marill:No Answer
| Joelle Donofrio-Odmann:No Answer
| Jon Rittenberger:No Answer
| Jose Cabanas:DO NOT have relevant financial relationships
| Paul Snobelen:DO NOT have relevant financial relationships
| Angus Jameson:DO NOT have relevant financial relationships