Automated External Defibrillator Q&A
What is an AED and why is it necessary in cases of sudden cardiac arrest?
AED stands for automated external defibrillator, a computerized medical device that analyzes a heart rhythm to detect cardiac arrest and delivers an electric shock to the heart (defibrillation) if necessary. If the AED determines defibrillation is needed, the device prepares to shock and prompts the rescuer to activate a shock, or depending on the device, administers the shock automatically. Audible and/or visual prompts guide the user through the process, making the device very easy to use. A shock from an AED is the most effective treatment for sudden cardiac arrest.
What happens to the heart when someone has a sudden cardiac arrest and how does the AED help?
A person who suffers a sudden cardiac arrest will collapse, stop breathing normally and become completely unresponsive. This occurs most commonly because the heart develops an abnormal rhythm called ventricular fibrillation (VF) during which the heart quivers and does not pump blood. If an AED detects a VF cardiac arrest, it can deliver an electric shock to the heart muscle, momentarily stunning the heart and stopping all activity. This gives the heart an opportunity to resume a normal rhythm and again pump blood.
Can Automated External Defibrillators (AEDs) save the life of a child who has a sudden cardiac arrest as a result of congenital heart disease or other pre-existing cardiac causes?
Yes, if these children develop sudden cardiac arrest with a “shockable” abnormal rhythm (such as ventricular fibrillation or ventricular tachycardia). Children or adults who develop cardiac arrest caused by a slowing of the heart rate (bradycardia) or cardiac standstill (asystole) cannot be treated with an AED. These rhythms do not respond to electric shocks, so the AED will not allow a shock to be activated and standard CPR measures should be performed.
Will an AED save every person who suffers from Sudden Cardiac Arrest?
No, an AED will not save every person who suffers from sudden cardiac arrest. No device is a foolproof means of survival. As indicated above, children or adults who develop cardiac arrest caused by a slowing of the heart rate (bradycardia) or cardiac standstill (asystole) cannot be treated with an AED. These rhythms do not respond to electric shocks, so the AED will not allow a shock to be activated and standard CPR measures should be performed.
Is it possible to administer a shock from an AED to an individual who does not need such a shock?
No, the AED will not allow a shock to be administered unless a specific ‘shockable’ cardiac rhythm is detected.
Can you perform CPR with an AED in place?
CPR should be performed until the AED is available and in place. Most devices will prompt the user to stop CPR while it analyzes the rhythm. When the device prepares to shock the patient, no person should be touching the patient. CPR should be continued if no shock is advised or if the shock in unsuccessful.
What does an AED cost and how will schools secure funding to implement AED programs?
The cost of an AED can range from less than $1,000 to over $3,000. The price can vary depending on the number of units purchased and features included. Schools may budget for needed medical equipment and to purchase AEDs for their program or they may seek outside corporate funding from the local community. Many schools have found success in funding their AED equipment and training through donations from local community businesses. There are also state and national organizations that may be able to assist with funding to purchase AEDs.
Will schools implementing AED programs have increased liability?
AED programs are included under national Good Samaritan laws. In addition, the federal Cardiac Arrest Survival Act (CASA) provides additional Good Samaritan protection, including limited immunity for those who provide emergency treatment with an AED. Additionally the State of Texas approved legislation in reference to AEDs and limited immunity for those AED owners who comply with the conditions of the AED legislation that was effective September 1, 1999 (see HB 580, 76th Regular session, 1999).
Why do schools need AEDs?
Sudden cardiac arrest (SCA), or massive heart attack as it is sometimes known, kills 450,000 people in the U.S. alone each year. It can strike anyone: your students, staff, faculty or visitors. Even a seemingly healthy person can suffer cardiac arrest without warning. According to the American Heart Association (AHA), as many as 50% of SCA victims have no prior indication of heart disease - their first symptom is cardiac arrest.
The only definitive treatment for SCA caused by an abnormal heart rhythm is a defibrillation shock — an electrical pulse through the heart — which restores a normal heart rhythm. The chance of an SCA victim's survival decreases by 10 percent with every minute that passes, so in order to be effective, defibrillation treatment must be administered within the first few minutes of SCA.
Who can help my organization implement an AED program?
There are several factors to consider when implementing an AED program, such as the selection of an AED, lay-rescuer training, physician oversight, determining optimal placement and developing ongoing quality assurance programs. Organizations such as the AHA and American Red Cross (ARC), along with AED manufacturers and/or distributors, can assist your superintendent, principal, school board, athletic trainer or school nurse with all facets of a comprehensive AED program.
Why can't we just call 911?
There is a very good chance emergency medical services (EMS) cannot respond fast enough to save someone in cardiac arrest. In fact, the national average response time is 10-12 minutes, so even the best EMS responders could have difficulty arriving in time. Time to defibrillation is the most critical factor in promoting a complete recovery from an arrhythmic sudden cardiac arrest. Besides traffic, consider the time needed to make it to a patient's side on a remote athletic field or in a crowded auditorium, for example. AEDs offer a practical way to save more lives because they are designed for use by nearly anyone. Widespread deployment of AEDs gives SCA victims the best chance of survival.
Where would we place our AEDs?
Most AEDs have convenient delivery systems that allow for mobile and stationary placement throughout a facility to support the 3-5 minute response time recommended by the AHA. Some key areas to place AEDs in your facility could be:
- In student health areas or with the school nurse
- In cafeterias, auditoriums, and gymnasiums
- Near a fire extinguisher
- In a reception or common area
- With athletic trainers
- With a security officer
Wherever your AEDs are placed, they should be visible and easily accessible at all times.
Sources: American Heart Association, Cardiac Science Corporation