Automated External Defibrillators: Saving Lives Through Accessible Technology

Automated external defibrillators (AEDs) are portable electronic devices that can diagnose and treat cardiac arrhythmias, particularly sudden cardiac arrest, through defibrillation. As the technology has advanced and become more affordable and user-friendly over recent decades, AEDs have increased in public spaces across the UK and worldwide.

Automated External Defibrillators Guide

They can be life-saving promptly in the critical minutes before emergency services arrive. However, there are still barriers to maximising the potential of AEDs to save lives. Exploring the technology, effectiveness, availability, legal considerations, and remaining challenges around public-access AEDs can give insight into how this equipment could have an even more significant impact.

How Automated External Defibrillators Work

An Automated External Defibrillator (AED) can automatically analyse heart rhythms and deliver an electric shock when it detects the irregular rhythms associated with sudden cardiac arrest.

Cardiac arrest occurs when the heart malfunctions and stops pumping blood effectively, usually due to an electrical disturbance in the heart’s rhythm called ventricular fibrillation. AEDs use audio and visual commands to guide the rescuer through the process.

They have sticky pads with sensors called electrodes that get attached to the victim’s bare chest. Once connected, the AED monitors the heart’s rhythm through the electrodes. It determines if an electric shock is needed to restore the abnormal heart rhythm.

The electric shock delivered by an AED is called defibrillation. It allows the heart to resume beating with a regular rhythm. This increases the chances of survival in situations of sudden cardiac arrest. Unlike manual defibrillators used by paramedics, automated models determine on their own whether a shock is required.

They then give verbal instructions to the rescuer to press a button to deliver the shock. AED algorithms have become highly accurate at determining when defibrillation is appropriate.

Effectiveness for Cardiac Arrest

Various research studies have demonstrated that early defibrillation with an AED can dramatically improve survival outcomes from out-of-hospital cardiac arrest. According to RESUS, the chances of surviving a cardiac arrest fall by around 10% for every minute defibrillation is delayed.

They cite data showing an average survival rate of 40% if a public member retrieves and applies an AED within 3-5 minutes.

The quicker defibrillation can be administered, the better the prognosis. Cardiac arrest survival rates are over 60% in places like casinos or airports where AEDs are immediately available. Communities that have invested in widespread public access to AEDs, including robust training in their use, have achieved cardiac arrest survival rates of over 40%.

In stark contrast, the BHF says the national average for out-of-hospital cardiac arrest survival in the UK remains below 10%. A shocking statistic in any year.

Widespread availability of AEDs would undoubtedly play a significant role in improving these statistics.

Availability and Awareness

There are over 100,000 AEDs registered across the UK, with more installed each year.

The number in public places has substantially grown over the past two decades. Still, availability remains patchy compared to countries like Japan and parts of the US. Efforts to highlight locations through database registries like The Circuit in the UK and smartphone apps like GoodSAM that connect lay rescuers to nearby AEDs during emergencies are helping increase awareness.

However, currently, only around 44% of cardiac arrests receive defibrillation before ambulance arrival.

Experts argue the proliferation of visible public access AEDs is vital for maximising their life-saving potential. Increased visibility reinforces to rescuers and the broader public that swift action can save lives in medical emergencies.

Clear signage and demarcation of the nearest AED can significantly impact survival rates. Maps of known locations both online and across transport hubs, shopping centres, and community spaces also strengthen emergency preparedness and awareness.

Alongside availability, regular awareness campaigns and CPR/AED training are equally important. Bystanders trained in using AEDs demonstrate faster response times, better adherence to safety guidelines, and greater willingness to employ the technology during an emergency.

Legal Protection

Concerns over legal risk have historically deterred some organisations from purchasing a publicly accessible AED for their premises. However, laws exist to protect good Samaritans from litigation after voluntarily coming to someone’s aid in an emergency.

The Social Action, Responsibility and Heroism (SARAH) Act of 2015 enshrines protection around defibrillator use in legislation in England and Wales. It provides legal reassurance for those acting responsibly, in good faith and without recklessness.

Those retrieving or using an AED to assist someone in an emergency cannot be sued for unintentional harm.

The Resuscitation Council UK has emphasised that members of the public should not hesitate to intervene with CPR and defibrillation for fear of legal repercussions under this act. Rescuers can rely on robust legal protections if the equipment is used in line with manufacturers’ instructions and training.

Good Samaritan laws like SARAH help reinforce that AED use by laypersons is safe and encouraged.

Remaining Barriers to Maximise Life-saving Impact

Significant barriers still restrict AEDs from achieving their full life-saving potential across communities. The two most significant impediments are inconsistent public funding provision for community programmes and unclear pathways for integrating emerging technology.

AEDs have been commonly installed in public settings like transportation facilities, government buildings, shopping centres and stadiums. However, expanding provision equally across less affluent communities has proven difficult without coherent funding strategies in many regions.

Postcode lotteries persist regarding access to sports and youth facilities, pharmacies, and high footfall areas that could otherwise house potentially life-saving equipment.

Dedicated funding pools that allow community organisations to apply for device installation, maintenance and associated training remain the exception, not the norm.

Unclear approval pathways for emerging AED technology also hamper progress. For instance, drones enable AEDs to be launched to emergency GPS locations more rapidly than ambulances.

However, uncertainty about legally integrating them into emergency care systems has stalled mass rollouts. Policy conversations are still catching up with the innovative means modern technology permits for detecting cardiac arrest incidents quickly and transporting defibrillators effectively to maximise patient response times across neighbourhoods or vast rural areas.

The technology of automated external defibrillators has enormous power to save lives when integrated effectively into community emergency care frameworks. There is considerable scope for growth, increasing provision, streamlining training and better supporting life-saving actions amongst the public, according to medical bodies like the Association of Ambulance Chief Executives.

Broader establishment across the UK to match countries setting global benchmarks for cardiac arrest survival will require addressing funding gaps for under-resourced areas and innovating how AEDs can be deployed for time-critical emergencies in the future.

With resolve and ingenuity, public access defibrillation still offers untapped potential for preserving thousands more lives nationwide.