AED Placement Best Practices
How many AEDs should a facility have?
When responding to someone who has suffered Sudden Cardiac Arrest (SCA), immediate action is critical for saving lives. The sooner that bystanders treat the SCA victim with a defibrillation shock from an Automated External Defibrillator (AED), the more likely that they will survive.
According to the Occupational Health and Safety Administration, of the 350,000 people who die from SCA outside the hospital in the United States each year, 10,000 lives are lost in the workplace. By having defibrillators throughout offices and facilities, businesses are able to protect the lives of both their workforce and visitors. Office AED programs save lives, but only if responders are able to quickly find and use an AED during an emergency. We’ve created this guide to help answer questions about where and how many AEDs should be in a facility.
Rapid response saves lives!
Sudden Cardiac Arrest is when the heart muscle suddenly stops beating properly. Without a viable heartbeat, the heart is no longer able to circulate oxygen-rich blood throughout the body to the brain and other vital organs as needed for survival. Victims of SCA will die within minutes if they do not receive immediate treatment including a life-saving defibrillation shock from an AED. In fact, a victim’s survival chances decrease by 7-10% every minute that defibrillation is delayed.
Leading organizations like the American Heart Association recommend providing defibrillation as soon as possible. In one study, by providing defibrillation within 3 minutes of witnessed collapse due to Sudden Cardiac Arrest, security officers in casinos were able to save 74% of SCA victims. Given that only about 10% of SCA victims survive in the United States, the benefits of early defibrillation are clear!
If average AED response times in the United States can be decreased by just 1 minute, survival rates from SCA will increase by 10% – that’s the equivalent of saving an additional 35,000 lives per year!
What’s the ideal AED response time?
The American Heart Association states that, “Effective AED programs are designed to deliver a shock to a victim within three to five minutes after the person collapses.”
How do you calculate estimated AED response times for your facility?
When calculating the ideal response time with an AED for a facility, AED managers often use the following approach to determine how many AEDs they need and where their AEDs should be placed.
- Begin by selecting an initial “central” location for the AED. This might be your first instinct as to where the AED might go. For instance, you might choose a common hallway, kitchen, or break room. Let’s call this the “AED Location.”
- Travel to the farthest location at your facility from the proposed AED Location. This might be a corner office on the opposite side of the building. For our evaluation purposes, this is where we’re going to assume a Sudden Cardiac Arrest could take place. Let’s call this the “SCA Location.”
- Once at the SCA location, start a stopwatch and walk at a brisk pace from the SCA Location to the AED Location.
- When you arrive at the AED Location, take note of the time. This is your halfway point. You can either double your time to calculate the roundtrip time or you can continue timing yourself as you walk back to the SCA Location with the AED.
- Now you have an approximate roundtrip response time to a witnessed sudden cardiac arrest!
- Repeat these steps in other locations throughout your facility that you think might be of a similar distance. Together, your list of response times will serve as an outline of how long it takes for you to get from different places at your facility to the AED and back.
Repeat this process for all locations in which you operate, such as your satellite locations, distribution centers, and more.
After using the steps above, if you find that it is taking you longer than 3 minutes to retrieve the AED (roundtrip, from the SCA Location to the AED Location and back), you should consider installing additional AEDs.
In many buildings, such as large, tall office towers, it’s common to have at least one AED per floor.
Keep these guidelines in mind:
- The example above assumes that you witnessed the cardiac arrest and attempted to retrieve the AED immediately.
- You knew what to do, but only some out-of-hospital SCA victims receive bystander CPR and even fewer receive defibrillation with an AED.
- You know exactly where the AED was located. This allowed you to walk directly to the AED without spending additional time looking for a unit, asking others for help, or, perhaps, taking wrong turns during your response.
- The example above doesn’t include the time it takes to power on the AED, apply the electrode pads, and defibrillate the patient. It should be expected that untrained responders that aren’t familiar with your AED brand will take longer to respond.
- Expand the definition of your facility beyond your building’s walls. Make sure to account for areas like your building’s parking lot or other areas in which your staff or customers might occupy.
As you can tell, having additional AEDs for better coverage can facilitate rapid response in the event of an emergency. It is also important to let your staff and visitors know that you have a lifesaving AED program through widespread AED awareness initiatives and CPR/AED training!
Consider additional barriers and obstacles
All facilities have barriers or other obstacles that might slow down your response times.
How do you calculate estimated AED response times for your facility?
For example, when you practiced the steps above, did you find that you had to traverse up stairs? Were there any locked doors? Even common office equipment can slow down your emergency response.
Here’s a list of common barriers and obstacles that might slow you down. Be sure to think about whether your facility has any of these restrictions and account for them during your AED placement planning process:
- Locked doors, including locked offices, or doors with special keycode access that might not be available to all potential responders
- Cubicles or desks
- Separate buildings
- One-way door access
- Crowded rooms like cafeterias or busy entryways
Tips for AED Placement
Time of day you perform your analysis
Your initial reaction might be to try to time your mock emergency response when the office is slow and there are fewer distractions, but it actually may make more sense to try it during a normal time of day. This gives you a more realistic idea of what could be expected if an emergency were to occur during your facility’s normal office hours. It is possible that the hallways are more crowded, new obstacles emerge, and there are other unknowns that might be hard to replicate during a slower time of day. These observations can help you form a more well-rounded opinion as to the appropriate placement of AEDs.
Rate of incidence
In addition to planning how many AEDs you need based on the response time process described above, AED managers should also evaluate whether or not there are select locations at their facility where there is higher risk for Sudden Cardiac Arrest such as:
- On-site fitness facilities
- Workplace fitness areas are a wonderful employee perk, but given the increased likelihood of experiencing cardiac arrest during vigorous exercise, fitness areas should also have AEDs to protect employees.
- A high volume of personnel
- Locations like auditoriums, large conference rooms, or cafeterias are common locations for AEDs. The more people that congregate in one area, the increased likelihood of a possible cardiac arrest. For this reason, AEDs are popular at highly populated locations like airports, theme parks, and shopping malls.
All facilities are different and your industry might have additional risks, so be sure to think about whether or not your location has any specific exposures that might increase risk and warrant AED placement.
ADA Guidelines and Properly Mounting your AEDs
The American with Disabilities Act has guidelines governing the accessibility of lifesaving equipment. The guidelines involve how far objects protrude from the wall and how high objects are mounted.
- Projection Requirements (section 28 CFR 36,4.4.1) specify that objects projecting from walls with their leading-edge between 27” and 80” above the finished floor (AFF) shall protrude no more than 4” into walks, halls, corridors, passageways, or aisles. Fayetteville Apartments for Rent with Washer & Dryer
Mounting Heights (Section 28 CFR 36, 4.2.5, and 4.2.6): Guidelines exist for cabinets and extinguishers that provide safety and/or access to safety equipment. The standards call for handles (including cabinet handles) to not be installed higher than 48” AFF for cabinets that allow for only a “forward approach in a wheelchair” to the object; and no higher than 54” AFF for those objects which allow for parallel approach.
Note: the National Fire Protection Association (NFPA) also governs the placement of AEDs, calling for a maximum mounting height of 60” AFF to the top of the cabinet. Therefore, satisfying AHA requirements will also meet NFPA requirements.
Other AED Placement Considerations
When might you need fewer AEDs?
In some situations your facility may need fewer AEDs than you calculate using the “timed” AED Placement process described above. Some specific examples include:
- Unoccupied large buildings and vacant areas
- Seasonal warehouses may only require the deployment of AEDs during staffed times. The AEDs might be re-located or re-allocated to other areas during the “off-season.”
- Industries like security, who carry AEDs with them, might be able to respond quickly in a vehicle. These mobile AEDs may decrease the need for as many AEDs in fixed, physical locations as seen with other industries.
If your facility needs several AEDs but they’re not placed in highly visible areas, or they’re stored behind locked doors, responders won’t be able to easily grab and utilize the lifesaving technology in an emergency. To maximize their effectiveness, AED units should be available to all potential responders.
AED visibility can be increased by placing devices in highly-trafficked areas and by using signage. 3-D wall signs above your AEDs will enable responders to find the nearest AED across a large room (much like spotting the nearest emergency exit) which can save precious time.
Providing staff with informational materials about the AED program and letting personnel know what to look for can also increase AED visibility.
With proper AED visibility, awareness about the program, and the right number of units for your facility, you are helping ensure the safety of your workforce and visitors!