I asked Dr. Asif Ali, a renowned cardiologist in Texas, “Where should AEDs be placed to improve survival rates from ~10% for Out of Hospital Sudden Cardiac Arrest (SCA)?”, and his response was simple… “Everywhere,”. I can almost guarantee you that you’d receive the same answer if you asked any physician that question… and when they give that response, they really do mean it. That’s because there is no formula to determine exactly when and where a person is going to experience SCA. It’s called Sudden Cardiac Arrest for a reason.
To date, for the most part, AED manufacturers and communities have taken the approach of placing public access AEDs in locations that often have a large amount of people present at one time such as airports, gyms, shopping malls, large office buildings, and casinos. The logic for this approach is that there’s a higher chance that a SCA incident will occur in one of these more densely populated areas than a less populated location such as a restaurant or even a person’s residence. However, it’s clear that the current placement strategy for AEDs is counterintuitive to what the data shows, as its been found that over 70% of cardiac arrests actually occur in the home or a similar private setting – two locations where AEDs are rarely found.
The reality is that in order for there to be a meaningful increase in survival rates from SCA, AEDs need to be immediately accessible to anyone, anywhere, anytime. Here are four reasons why AEDs are not:
1. Lack of Education Regarding SCA & AEDs
Most people aren’t really aware of SCA, and the importance of having an AED accessible. While there has been an ongoing public awareness effort for years on the importance of knowing how to perform CPR and use an AED, it has been largely ineffective due to the fact that AEDs have been presented to the general public as a “medical device,” instead of as a tool that can be used to help someone in their greatest time of need.
When the average person looks at an AED… it looks like a big, intimidating, bulky box, and it’s often assumed that this product can only be used by trained medical professionals (that’s not true). Couple that with the fact that current AED manufacturers place little emphasis on educating the general public on their devices and building a brand that is synonymous with social good and helping others… it’s no surprise that most people don’t know how important AEDs are, and that it would be prudent for a youth basketball coach to have one in his bag at every practice and game.
2. AEDs Lack True Mobility
It’s true that all AEDs are portable… but none of them are mobile enough to be taken on-the-go. They are currently designed to be stationary devices until they are put to use during an emergency. Most AEDs weigh several pounds, and are typically stored inside a carrying case that adds additional bulk and weight. For that reason, these devices are most often placed in wall cabinets, and are rarely carried around in a backpack, purse, or even the glove box of a car.
The fact that AEDs are not designed to be carried around and taken on-the-go serves as a major barrier to these devices being accessible at all times. Potential users such as law enforcement, athletic trainers, sports coaches, volunteer first responders, and individuals at-risk for cardiac arrest need a product that they can take with them anywhere without any hassle, and current AEDs often don’t offer them that capability.
3. AEDs are Expensive
The most affordable AED on the market retails for $1,200. The higher end models only cost $3,000. That’s all you really need to know…
4. AEDs are Burdensome to Maintain
If price wasn’t enough of a barrier to purchase an AED, then let’s add a burdensome, expensive, and completely manual maintenance process to the mix.
Once you own an AED, you are required to replace the battery and pads every 2-3 years, which costs anywhere from $150 – $400 (depending on the AED model). Not only are you required to pay this additional expense, but you’re also forced to remember to replace these components (and if you don’t want to remember yourself, you have to pay more money to have a third party service remember for you).
In addition, the only way that you know if your device is functional or not is by physically going to check whether there’s a green (indicates that AED is functional) or red (indicates that AED is non-functional) light flashing from your AED. If there’s a red light flashing, well, there’s really no way to know what the actual problem is with the device. Think about this scenario… what if the red light starts flashing after the last time you checked your AED and now someone needs to use the device during an emergency situation and it’s non-functional for some reason.
That scenario unfortunately happens far too often, just like it did in Miami-Dade County Schools just last year.
Let’s be clear… by no means am I discouraging organizations and people from purchasing AEDs. You should buy an AED. These devices are unbelievably important, and have/will continue to save lives in situations where they are accessible.
All I am trying to do is present the primary reasons why after twenty plus years of public access AEDs being on the market, these devices are still not anywhere close to how accessible they should be at this point in their history.
If the 70% of cardiac arrests that occur in a personal setting are going to have any chance of being addressed, AED manufacturers need to take a completely different approach to: (1) branding themselves as approachable and connected to the average person such that they can be viewed as an educational resource, (2) designing their products such that they are more practical for a wide range of potential customers, and (3) making the cost and burden of ownership more reasonable and less demanding.
Because let’s face it… right now, the status quo isn’t good enough.