“当我们设计并制造每一个设备时，就好像它是我们所爱的人的生命所依。”这是我们在华盛顿特区西雅图市的设计和制造团队对客户的承诺。这一承诺被每个工作人员深深地烙在心中。我们实现这一承诺的主要途径就是尽可能地将我们的自动除颤系统设计得便于使用，使毫无经验的施救人员在相当大的压力下也不至手足无措。除颤器必须能够帮助非专业施救者渡过难关，而不能让他们觉得碍手碍脚。以下的设计元素，使我们的自动体外除颤器的使用更加便捷，这种便捷性在一些发表的研究成果中被证明是无法超越的。1,2,3
广泛的用户检测。在设计过程中，HeartStart设备的人性化因素得到不断地检测，并被一次又一次地加以改进。这种检测用普通人作为测试对象，将其置身于模拟的心脏骤停情境中。他们与设备的互动用录像记录下来，并仔细加以研究。让使用者感到不确定或迷惑的每一点都被看作是设备用户界面的一个设计缺陷。 这些设计中没有涵盖的部分可能导致设备使用方面一系列潜在的错误和死角，从而可能导致急救工作的失败。这些设计缺陷都在设备投入市场之前进行了改进和完善。
恰当的语音。我们的除颤器能够对您进行语音指导。您听到的指导您操作的声音，经过我们的精心选择，将各种特性完美结合在一起：
- 镇定。施救人员在处于真实的急救情境时会分泌大量的肾上腺素。因此，他们所需的是镇定的表现，让他们可以清醒地思考，并建立起足够的信心，使他们能够冷静并胜任急救工作。
- 与救援人员建立良好的关系。施救者会与相关人员自然而然地建立密切的关系，我们的设计人员倾向于使用这些人的声音用于语音指导。如果施救者“喜爱并且敬重”这个声音的主人，那么他就会感觉所使用的设备更加人性化。施救者和设备更容易形成积极、有效的团队。
- 权威性。人们在巨大的压力之下很难做出决定。 因此，我们选择的声音应该使施救者自然地完全信任这台设备，能够认真倾听，并完全忠实地按照其指示进行操作。
- 文化敏感性。我们设备能用多种语言进行语音指导，这些语种的配音人员都是各个国家的工作团队在当地选取的，忠实于该设备使用地区的文化，从而在更高的层面体现了我们以人为本的特性。这种特性促使设备与用户在巨大的环境压力之下建立起一种和睦的关系。
Detailed instructions, yet not wordy. Voice instructions should be sufficiently detailed to take an untrained user through a rescue. This is a foreign and frightening experience for the responder. They may have no training, or training on a different device. So voice instructions must make sure nothing is left to chance in guiding a responder to perform a procedure they seldom practice. Yet sentences must be short, and there should be no unnecessary words that do not contribute to understanding. It is our experience that long sentences potentially cause confusion and frustration for a stressed responder. They may require more concentration than the responder is able to provide.
Instructions paced to your actions. Voice instructions are designed to move along at the user’s pace. They should not outpace the user, leaving them behind, anxious, and lost. And they should not slow the responder down, wasting valuable time, leaving them frustrated, and tempting them to “go it alone”, acting before being instructed, and possibly acting incorrectly. HeartStart defibrillators are uniquely able to know where the user is in the response and closely pace instructions accordingly. The HeartStart FRx and OnSite (HS1) have a unique feature our engineers call “pad fiddle”. The pads can sense when they are first being touched and manipulated. This helps the AED know more precisely than other AEDs where the user is in their response. The device will then adjust instructions accordingly to provide instructions appropriate to the user’s progress. This makes for a more human interaction between user and device, like there is a coach watching them and guiding them step by step. It is designed to help make the responder more confident and effective, and less distracted from the task at hand.
Special emphasis. If we find during user testing that a step or key point tends to sometimes be missed or glossed over by the user, we will place special attention-getting emphasis on that step when recording the final voice instructions. We find this results in better user performance.
Instructions not followed are re-phrased. When a voice instruction is not performed, the HeartStart AED recognizes it, and stays with the responder to invite them again to perform the step. But we don’t simply repeat the same instruction over and over again, like many other AE Ds. If the responder did not understand the instruction the first time, we don’t assume they will the second, third or forth time the instruction is repeated. We assume that maybe the responder does not understand what the device is asking them to do, and what is expected of them. So we express the instruction using different words that maybe the responder will better understand.
Visual instructions communicate with out overloading the senses. Most users rely on the voice instructions. However HeartStart AEDs also provide visual queues that are more graphical and less written. These graphics-based visual instructions are designed to communicate instantaneously with minimum reading and interpretation, yet not compete with the voice instructions for the user’s limited attention span. Think of them as dashboard lights on your automobile. This is also designed to improve understanding for users that may not be as fluent in the device’s language. In user tests, respondents were actually able to rely on these graphical queues to perform a rescue in the absence of voice instructions.
Reminder to call for help. We include an instruction to call emergency services, just in case the responder overlooked that critical step.
CPR Coaching. Our FRx and OnSite (HS1) device offer the inexperienced responder detailed CPR coaching to help them recall their training. It is there on demand for those who need it. Simply press the blue i-button when invited. CPR is a difficult motor skill that, once learned, is not well retained when not put to use.4 Also, responders may have received their most recent training years ago, and CPR guidelines may have been different then. CPR coaching is designed to help the stressed user remember their training and to encourage performance of CPR according to current guidelines. It includes coaching for the more complex motor actions, such as the mechanics of opening an airway or the depth and pace of chest compressions. As one Red Cross instructor put it so well, “That little blue button is the answer to all their anxieties about CPR.”
Infant/Child Key. In user testing, and in anecdotes from customers, people love the FRx Infant/Child key. It obviates the need to change pads for the rescue of a child, saving steps. By inserting the key, which is shaped to instinctively convey to a stressed responder “child!” (the key resembles a teddy bear rattle), the device is ready for a pediatric rescue. It also shows the correct pad placement for children. All subsequent voice instructions and the shock dosage are appropriate for a child.
Easy battery replacement. In the unlikely event that a device battery will need replacement mid-rescue, we design our batteries to pop out and pop in easily, in one quick action. Chances are you will not have to use this feature in a rescue, but it is reassuring that you can replace a battery smoothly and easily if needed, minimizing unnecessary frustration or distraction.
At Philips, we believe it is the little things that make the difference between a satisfying, efficient rescue and a frustrating and failed rescue. So we pay attention to the details. And we test on users. And test again until it is right.
Because an AED should pull the stressed responder through, not get in their way.
1 Andre et al, Prehospital Emergency Care 2004; 8:284-291.
2 Eames et al, Resuscitation 58 (2003); 25-30.
3 Fleischhackl et al, Resuscitation 62 (2004); 167-174.
4 American Heart Association Guidelines 2005. Circulation 2005; 112.