In the US the use of automated external defibrillators (AEDs) is now widespread following The Public Health Improvement Act (2000), which provides for placement of AEDs in all federal public buildings.
Recognition of the importance of Public Access Defibrillation has spurred on the widespread adoption of public access schemes. More than 50,000 AEDs have been deployed in public places, such as police cars, hotels, sports stadiums, schools and manufacturing plants. The FAA has ruled US airlines must carry AEDs.
Use of AEDs is viewed as being critical to increasing survival rates from sudden cardiac arrest. These life-saving devices are even being made available to those who want the ability to respond to incidents of cardiac arrest within the home, where some studies have shown 70 per cent or more of arrests happen.
AEDs have been designed to help people of various ages and abilities use the technology successfully when faced with an emergency situation. Defibrillator technology has evolved significantly during the past decade, resulting in automated devices that are portable, intuitive and simple to operate, with audible and/or visual prompts guiding the user through the process.
Adhesive pads are placed on the victim's chest and these pads capture the victim's heart rhythm and transmit it to the AED. A computer inside the defibrillator analyses the heart rhythm and advises the operator whether a shock is needed.
Studies in the US have demonstrated the ease of use of AEDs even for children as young as 10. During mock cardiac arrests, children delivered shock therapy with only modestly slower rates than paramedics. Studies have also shown that lay persons aged 60 and older can successfully operate an AED after watching a short instructional video.
This begs the question - If AEDs are so easy to use, why is formal training needed? Safe use of an AED requires more than the simple operation of the device. An AED operator must know how to recognise the signs of sudden cardiac arrest, when to activate the emergency services and how to perform CPR. It's also important to receive formal training on the AED that will be used. This way the user becomes comfortable with the device and can successfully operate it in an emergency. Training also teaches the user how to respond to special situations such as placement of AED pads when the victim has an implanted pacemaker, a very hairy chest or a medication patch. Training improves CPR skills and ensures the shock is delivered in the shortest time possible.
The Irish Heart Foundation's four-hour Heartsaver AED course is designed to teach the basics of CPR and AED operation. Participants watch videos and then practise the techniques on a mannequin following a number of role-playing scenarios. Certification is valid for two years and the IHF recommends refresher courses every 90 days.