Public Perceptions and Utilisation of Automated External Defibrillators(AEDs) in Ireland: A quantitative and qualitative analysis of awareness, confidence and barriers to AED use in 2025

Abstract

Out-of-hospital cardiac arrest (OHCA) affects approximately 5,000 people annually in Ireland, with survival rates as low as 8.4%. Automated External Defibrillators (AEDs) can significantly improve survival outcomes if utilised within 3-5 minutes of cardiac arrest. Despite approximately 9,000 AEDs nationwide, public utilisation rates remain critically low at 11% pre-emergency medical services arrival, highlighting a significant gap between device availability and effective public intervention. This study comprehensively investigated public perceptions and utilisation patterns of AEDs across Ireland in 2025. Key objectives examined: (1) associations between demographics and AED knowledge, (2) perceived barriers versus understanding levels, and (3) relationships between awareness levels and demographic responses. A mixed-methods approach employed both electronic (n=379) and hard copy (n=6) surveys. The predominantly quantitative questionnaire assessed AED awareness, confidence levels, training exposure, and perceived barriers, analysed using descriptive and inferential statistics. Qualitative data, from the open-ended questions, were analysed using Braun and Clarke's six-phase thematic analysis framework. Results revealed significant knowledge and confidence gaps. Only 76.1% of respondents knew AED locations within their community, while confidence in recognising when to use an AED was low (average self-efficacy score: 2.8 on a 5-point scale). Willingness to intervene varied by social context, demonstrating a bystander effect: 37% were very likely to use an AED when alone versus 27% in large groups. Key barriers included lack of knowledge or training (56%), fear of causing harm (47%), anxiety about taking responsibility (22%), and legal concerns (18%). Training emerged as the strongest predictor of intervention likelihood (66%). Gender disparities were evident, with females showing significantly higher fear of causing harm (86% vs 36% for males). Geographic concentration in Dublin (76%) limited rural representation. These findings underscore persistent deficits in AED awareness, confidence, and action readiness. Current public education approaches appear insufficient to overcome complex utilisation barriers. Effective AED utilisation requires multi-modal strategies simultaneously addressing legal, technical, and psychological barriers through demographic-responsive training, policy initiatives, and awareness campaigns to bridge the critical knowledge-action gap and improve OHCA survival outcomes.