Sudden cardiac arrest (SCA) is a serious medical emergency that affects thousands of people each year. According to statistics, approximately 356,000 out-of-hospital cardiac arrests occur annually in the United States, with a survival rate of less than 10%. However, the use of automated external defibrillators (AEDs) can significantly improve survival rates. Studies have shown that early defibrillation with an AED, within the first few minutes of cardiac arrest, can increase the chance of survival by up to 70%. Understanding what an AED is and ensuring its availability in facilities is crucial for timely intervention and improving outcomes in cases of cardiac emergencies.

Unfortunately, the state of Georgia does not have a requirement for AEDs in every building. However, there are specific types of buildings where AEDs are mandated by law. In Georgia, the Cardiac Arrest Survival Act requires AEDs to be present in public schools, colleges, universities, sports arenas. While these requirements cover some high-traffic locations, it is essential to recognize the importance of expanding AED availability to all public spaces, workplaces, and other areas where people gather. By having AEDs in your office and widely accessible, we can enhance the chances of immediate intervention and potentially save the lives of those around you. 

Let’s explore the key considerations and information regarding AEDs:

• What is an AED?
• When to use an AED
• Can an AED be used on an infant or a pregnant woman?
• Can an AED be used if they have an internal defibrillator or pacemaker?
• AED maintenance plan
• What AED should you have
• When you get an AED, you also need AED training

What is an AED?

An automated external defibrillator (AED) is a portable electronic device used to diagnose and treat life-threatening cardiac arrhythmias, specifically ventricular fibrillation and pulseless ventricular tachycardia. 

The acronym AED stands for “automated external defibrillator.” Let’s break down its components:

Automated: AEDs are designed to analyze a person’s heart rhythm automatically. The device assesses whether a shock is needed and delivers it accordingly, reducing the reliance on human judgment.

External: AEDs are applied externally to the chest of a person experiencing a cardiac arrest. The device uses adhesive electrode pads that are placed on the person’s chest to detect the heart’s electrical activity.

Defibrillator: A defibrillator is a device that delivers an electric shock to the heart. The shock interrupts the abnormal heart rhythm and allows the heart to reset and resume its normal beating pattern.

When to Use an AED

AEDs are used in the critical moments following a sudden cardiac arrest (SCA). An SCA occurs when the heart’s electrical system malfunctions, leading to a loss of normal heart rhythm. During an SCA, the heart may quiver or beat irregularly, preventing it from effectively pumping blood to vital organs.

Combined with CPR, using an AED is essential in this life-threatening situation. You should always use an AED whenever someone is in cardiac arrest, which means they are unresponsive and not breathing. It is important to note that an AED being automated means an AED cannot hurt anyone and will only deliver a shock if it is needed. If I were to put it on someone that their heart is working, it would not do anything since it doesn’t detect an issue. 

You should never be afraid to use an AED, since these devices are very smart. If you are doing CPR for someone, using an AED is imperative. Don’t waste time on deciding on if an AED is needed. It is the AED’s job to decide if it is needed, not yours. Your job is to just put it on the victim.

When an AED Doesn’t Deliver a Shock

While Automated External Defibrillators (AEDs) are highly effective in delivering life-saving shocks for most cases of cardiac arrest, there are specific heart conditions in which an AED may not deliver a shock. These conditions include:

• Asystole (Flatline): AEDs are not designed to deliver a shock when the heart is in a state of asystole, which is the absence of any electrical activity in the heart. In such cases, the focus shifts to performing high-quality CPR and activating emergency medical services.
• Pulseless Electrical Activity (PEA): PEA refers to a rhythm in which the electrical activity of the heart is present, but there is no effective pumping action. AEDs may not advise a shock for PEA. The rescuer should continue CPR and seek advanced medical help.

If the AED does not deliver a shock when it is expected, it is important to take the following steps:

1. Verify electrode (pad) placement: Ensure that the AED electrodes are correctly placed on the patient’s chest as per the manufacturer’s instructions and pictures on the pads. Incorrect placement can result in improper analysis and failure to deliver a shock.
2. Check battery and electrode connectivity: Ensure that the AED has sufficient battery power and that the electrodes are securely connected to the device. Faulty connections or depleted batteries can prevent the AED from functioning properly.
3. Continue CPR and reassess: If the AED does not advise a shock, continue performing high-quality CPR until advanced medical help arrives. Constantly reassess the patient’s condition and follow the guidance of the AED prompts.

Promptly applying an AED and following its voice prompts or visual instructions can increase the chances of survival. The AED will analyze the person’s heart rhythm and determine if a shock is necessary. If a shock is advised, the device will guide the user on when and how to deliver the shock. Remember, the goal of using an AED is to restore a normal heart rhythm and improve the chances of survival until advanced medical help arrives. 

For an introduction on how to use an AED, here is a short video:

To learn more about how to use an AED and get hands on practice by taking a CPR, First Aid, and AED course with First Response. We offer both in person group training and self paced online training. Join a class here or sign or request a class here.

Can an AED Be Used on an Infant, How About a Pregnant Woman?

A common concern is whether an AED can be safely used on infants. While AEDs are primarily designed for adult use, they can also be used for infants and children. Pediatric pads or electrodes are available specifically for this purpose. These pads modify the energy level to suit the smaller size and needs of young patients, ensuring the appropriate delivery of therapy. It is important to note that the placement of an AED for an infant is different. Contrary to what many may think, AEDs are safe to be used on pregnant women in the event of a cardiac arrest. The safety of AED shocks during pregnancy has been widely studied, and there is no evidence to suggest harm to the mother or fetus when an AED is used correctly. However, it is important to place the AED pads correctly, avoiding direct contact with the abdomen, as per the manufacturer’s guidelines.

Below is what AED pads look like which have pictures of where they are placed. Make sure to follow the guidance of the pictures on the pad regardless of age or gender.

Can an AED Be Used If They Have an Internal Defibrillator or Pacemaker?

One important consideration in using an Automated External Defibrillator (AED) is whether it can be safely used on individuals who have an internal defibrillator or pacemaker. While AEDs are generally safe to use in these cases, specific precautions should be taken to ensure the well-being of the individual. Here are some key details to consider:

AED shocks are unlikely to interfere with the operation of internal defibrillators or pacemakers. In addition, if someone is in cardiac arrest then the internal device is likely not working properly anyway, so using an AED can only help this person. These implanted devices are designed to deliver electrical signals to the heart or regulate its rhythm. The electric shock delivered by an AED is focused on the heart and should not disrupt the functioning of the internal device. However, it is important to place the AED pads at least one inch away from the implanted device to avoid any direct contact or interference. Note that this is the same rule for any implanted device including ports or even a piercing. In most cases, when these are surgically installed, they place them on the left shoulder to not interfere with a potential AED if needed.

AED Maintenance Plan

Once you have an AED in your facility, it is essential to establish a comprehensive maintenance plan. This includes routine checks to ensure the AED is in proper working condition, such as inspecting battery life, electrode pad expiration dates, and overall device functionality. 

• Designate a responsible person: Assign a dedicated individual within your organization or facility to oversee AED maintenance tasks. This person should be well-versed in AED operations, maintenance requirements, and regulatory guidelines. They will be responsible for ensuring the AED is always in proper working order and ready for use.
• Regular visual inspections: Conduct routine visual inspections of the AED to identify any signs of physical damage, wear and tear, or loose connections. Check that the device is clean, the display is functional, and the electrodes and pads are intact. Address any issues promptly and document the inspections.
• Battery checks: Regularly check the AED’s battery status to ensure it has sufficient power for operation. Follow the manufacturer’s guidelines for checking battery life and replace batteries before they reach their expiration date or when the AED indicates a low battery level. Document battery replacements and keep track of battery expiration dates.
• Testing and self-checks: Perform regular tests and self-checks as recommended by the manufacturer. This may include simulated shock deliveries or checks of key functions like battery, electrodes, and internal circuitry. Pay close attention to any error messages or alerts during self-checks and take appropriate actions if issues are detected. Maintain records of self-check results as part of the maintenance documentation.

Learn more about AED Maintenance Plans here.

What AED Should You Get?

While there are many great AEDs out there, here are our primary recommendations:

• The Philips HeartStart FRx AED is pretty much the top of the line. You can use the same pads for Adult, Child, and Infant you just tell the device when you are using it on a child or infant and it adjust. Meaning you don’t have to change pads which saves time.
• The Defibtech Lifeline VIEW / ECG AED is another top of the line AED with a screen that shows you every step as you go through in addition to explaining the steps verbally.
• The Philips HeartStart AED is a great device that is easy to use. Make sure you also get child / infant AED pads in case you need to use it on anyone under 8 or 55 pounds. This is one of the most popular AEDs because of it ease of use and reasonable cost.
• The Cardiac Science Powerheart G5 AED is another great option is for its easy of use and clear instructions.
• The HeartSine samaritan PAD is a great brand and the nice thing about Heartsine is the battery and the pads are in one unit. Meaning you only have to change out one thing as part of maintenance.

For any AED you purchase you should also purchase an AED Fast Response Kit, so you have the extra things you need like a razor, scissors, CPR mask, and more. If you are adding it to your facility then getting an AED cabinet to place it in a visible and easily assessable area is also important. If your type of work requires you to be outside often they even have waterproof cases for AEDs so you can take it with you.

Remember the most effective AED is the one you have with you and that you know how to use.

When You Get an AED You Also Need AED Training

Once your facility gets an AED, all staff should be trained on the use of the AED. Georgia and South Carolina laws require all “expected users” to have nationally accredited certification if there is an AED on-site. While anyone can use an AED, whether they are certified or not, if they are expected to use it as part of their job, they should be certified. 

We offer nationally accredited CPR, First Aid, and AED courses for schools across Georgia and South Carolina. Request an AED class here, sign up for an at your own pace class here, or learn more about our AED classes here.