AED – Defibrillator Information, Tips, & Advice

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First, what is an AED? What is a defibrillator? An AED (Automated External Defibrillator) is a portable electronic device that can audibly prompt and deliver an electric shock that will disrupt or stop the heart’s dysrhythmic electrical activity. The shock will not start a dead heart, but it will stop certain lethal rhythms and give the heart a chance to spontaneously re-establish an effective rhythm on its own. According to the American Heart Association, CPR rescue attempts using electric defibrillation or AEDs improves survival rates by as much as 49%. Also be sure to checkout our aed reviews area.

The fact that most sudden cardiac deaths occur away from hospitals is the reason why there are cardiopulmonary resuscitation (CPR) programs for EMS level personnel and for laypersons. Two early problems with recognizing and caring for heart attack patients are being resolved. The first problem, delay in starting CPR, has been dramatically reduced through the training of more citizens who can administer CPR before EMS personnel arrive. The second problem stems from the fact that many heart attacks are fatal no matter how soon CPR is started. These deaths are often caused by lethal heart rhythms that must be corrected as soon as possible if the patients are to survive. The special procedure needed to save some of these patients can now be done in a pre-hospital setting by emergency-care providers such as first responders and EMT s. This special procedure is called defibrillation, which is an electrical shock given to a patient’s heart in an attempt to disrupt a lethal rhythm and allow the heart to re-establish a normal rhythm.

EMT s and first responders have been learning how to assess and defibrillate certain lethal cardiac rhythms by using AEDs. Now many non-EMS individuals are being trained to use AED s because these lifesaving machines are being placed in shopping malls, at golf courses, on airplanes, in airports, and in many other public gathering and recreational places. The US senate has passed S.1488, the Cardiac Arrest Survival Act, which has two purposes. First, it instructs the secretary of Health and Human services to make recommendations to promote public access to defibrillation programs in federal buildings and other public areas across the country. This helps to ensure the health and safety of everyone by encouraging ready access to the tools needed to improve cardiac arrest survival rates. Second, the act extends good samaritan protections to AED users and to those who acquire AEDs in those states that do no currently have AED good samaritan protections. This protection will encourage laypersons to respond in a cardiac emergency and use an AED. This legislation will enable and encourage more placement and use of AED s in public places.

The cardiac arrest survival act is a critical step toward increasing cardiac arrest survival rates, but just as critical is the training of those who will use AED’s. Training will provide the information needed to understand the heart’s electrical system functions and dysfunctions and the procedures for assessing and providing initial care for a person complaining of chest pain and going into cardiac arrest. Training will provide information on operation of the AED, and practice time with the AED. Training will also demonstrate the setup and defibrillation steps and emphasize all necessary precautions to take when performing the AED’s special procedure. If the defibrillation is successful, the heart can regain or restart its normal rhythm.

AED Facts According to the American Heart Association (AMA)

• On an average day in the United States 1,000 adults die from Sudden Cardiac Arrest (SCA), a total of 350,000 per year. SCA is the result of an arrhythmia, where the electrical pulse of the heart goes out of control, causing the heart to quiver. Doctors don’t understand why this happens, but they do know that shocking the fibrillating heart is the only effective treatment.
• The American Heart Association estimates that 20,000 to 100,000 SCA deaths could be prevented each year if defibrillation was readily available. Electrical shock restores a heartbeat and circulation, but to survive neurologically intact, rescue must be swift.
• Defibrillation within the first minute of sudden cardiac arrest can save the lives of up to 90% of its victims. However, with each minute of delay until defibrillation, the survival rate drops by 10% (American Heart Association)

AED Regulations

Most states have local regulations about the use of an AED in a non-clinical setting. While laws vary somewhat, there are a few elements of AED regulation that are common to almost all states:

• Current training in an approved AED program
• Involvement of a physician medical director
• Limited liability for the user, employer, physician under “Good Samaritan” laws
• Regular machine maintenance as per manufacturer

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AED Similarities 

All new AED ‘s on the market are FDA approved. They all work reliably to perform the job they were designed to do. There is no supporting research claiming one brand will save more lives than the other.

All AEDs use visual and voice prompts to easily guide you through a rescue. They all operate similarly. Once you’re trained and certified in the use of an AED, you may use any model, anywhere.

All new AED s use biphasic waveforms to deliver life-saving therapy. It’s an industry standard.

All new AEDs perform electronic self-tests. They test their own circuitry and batteries regularly. The AED itself will let you know if it’s ready-to-use with a visual and/or audible indicator.

All new AED s come with a 5-year manufacturer’s warranty. You may find some companies selling AEDs with shorter warranties. This tells you they’re used devices.

AED Differences

Replacement batteries come at different costs for different AED’s. Basically, you will find differences in battery life, warranties, and features. To find your average battery cost per year, simply take the replacement cost of the battery and divide by the battery life. Some models offer rechargeable batteries. This is not suggested because it means you’ll have to take your AED out of service to perform battery maintenance.

Different AED models use different energy levels to deliver shocks. Many AED dealers will try to make this an issue, but it is not. Regardless of power output of any AED, it will use a proprietary waveform to deliver the shock appropriately at its own internal power setting suitable to the victim. Remember all AED’s are FDA approved and save lives equally.

There are different visual displays on each AED. Some models have large displays that are easy-to-see in different lighting conditions, others do not. In what sort of conditions could your AED be used? Another common question is whether or not to purchase an AED with an ECG display. One philosophy is that an ECG display is an unnecessary distraction for lay-rescuers since they may be unable to interpret an ECG anyway. It clutters an otherwise simple display. On the other hand medical professionals will use AEDs with ECG output so they can see and interpret what the AED is sensing. The choice is yours.

Some AEDs perform a more detailed internal self-test than others. As mentioned previously, all AED’s perform internal circuitry and battery checks and will alert you if there is a problem. Only a few AEDs check for the presence of electrodes during self checks. (if the electrodes are missing, these AEDs will indicate the problem). Some AEDs have their electrodes pre-connected so you can visually check for their response.

AEDs come in different sizes, weights, and colors. This is a matter of personal preference. We feel none of the AED models on the market are burdensome or difficult to use because of their size. Your preference may be portability if the need is to place the AED in a small first aid kit. Alternatively, some have had concerns about theft or misplacing a smaller device. Your application should determine what is right for you.

Some models have more detailed voice prompting. Not all AED ‘s say the same things. All AEDs use voice prompts to help you successfully shock patients out of cardiac arrest. Some models are capable of more specific prompting than others. One unique AED will prompt you through all of the steps of CPR. Your comfort level will help determine your choice.

Different AED models come equipped with different accessories. When comparing prices, understand what is included in the purchase of the device. For example, all AED s come complete with the device itself, electrode pads, and batteries. Some come supplied with an extra set of electrodes, a rescue kit, or even a carrying case.

See the full guide here

Example of an AED Procedure

The following is an example of the operational procedures for an automatic external defibrillator (AED).  Be aware each AED – defibrillator model will vary from one to other.

Once the leads are attached to the patient, the AED will automatically assess the patient’s heart rhythm, sense if a shock should be delivered, charge to the preset energy level, and deliver the shock to the patient. AED’s have voice synthesizers to alert the rescuer and give instructions that typically include “Stop CPR”, “Stand Back”, and “Check Breathing and Pulse”.

• If the defibrillator advises that a shock is needed it charges up and an alarm sounds when the machine is ready.
• Depending on the model it will automatically shock the victim or it may instruct you to manually shock. (may shock up to 3 times, 3rd shock is strongest)

Useful Resources

The American Heart Association

References:

American College of Emergency Physicians

First Aid Manual Copyright 2002 DK Publishing, Inc.