Abstract Sun904: Variability of Automated External Defibrillator Signage Across Six Continents

Abstract

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.