A Comprehensive Guide to Defibrillators

Nearly 400,000 people experience sudden cardiac arrest (SCA) outside of hospitals in the United States. About 120,000 of these occur in workplace or community settings outside of the home. Whether on the subway, at work, or simply enjoying a favorite baseball game, sudden cardiac arrest can happen anywhere and at any time. SCA remains the third leading cause of death in the U.S. with a low 6 percent survival rate.

The American Heart Association recommends public buildings like malls, parks, event centers, transportation hubs, churches, and other organizations keep an automated external defibrillator (AED) charged and ready on the premises. Research shows that having the right tools on hand, along with training staff members in CPR, can boost the survival rate. Despite popular belief, though AEDs are technologically complex devices, they are easy to use and easy to maintain and save lives.

Two Types of Defibrillators

Did you know that there are different types of defibrillators and a variety of companies to purchase them from? The two most common are automated external defibrillators and implantable cardioverter defibrillators.

Invented by cardiologist Frank Pantridge in the mid-1960s, AEDs are portable pieces of equipment, sophisticated yet surprisingly easy to use. The device uses a computer system to analyze a patient’s condition to determine if shocking the heart could save their life. AEDs are common in public buildings, especially gyms or athletic stadiums, as well as in transportation hubs. Major manufacturers, and the brands we sell, include HeartSine, Physio-Control, Defibtech, Cardiac Science, Philips, and Zoll.

ICDs are also common. As the name implies, patients receive an implantable device via surgery. An ICD is typically placed about 1 inch below the collar bone and consists of a built-in pacemaker, a pulse generator, and electrode-tipped wires. The wires run through the veins and into the heart, allowing the device to monitor heart rate and send an electric shock to normalize it if it becomes abnormal. A pacemaker is different than a defibrillator.

There are three additional types of defibrillators as well:

• Advanced Life Support Units – ALS units are common in healthcare facilities and ambulances and allow for medical personnel to monitor the patient’s heart and provide a shock when necessary. Most ALS units can double as an AED, although they monitor other vitals, such as temperature and oxygen levels, as well.
• Manual External Defibrillators – Manual external defibrillators are used in hospitals and should only be operated by trained physicians, paramedics, or other medical personnel. MEDs are used with electrocardiograms to help diagnose heart diseases. The doctor must manually diagnose the rhythm and determine what voltage should be used if a shock is necessary.
• Wearable Cardioverter Defibrillators – WCDs are for patients who have a high risk of going into cardiac arrest. Patients who have undergone bypass surgery or recently had a heart attack are likely to receive a WCD, which includes a vest and monitor that goes underneath the clothing.

When Should an AED be used?

Simply put, seconds matter during an SCA event. In fact, survival chances decrease by about 10% for every minute that SCA patients go without CPR and AED administration.

If you witness someone collapse and stop breathing, the issue is very likely sudden cardiac arrest. Call 9-1-1 and begin performing CPR immediately, as it can help to keep blood flowing through the vital organs. 

If you have access to an AED, apply it to the victim right away. Because they are computerized devices, you don’t need to worry if you have never used one or had any prior training. Simply follow the step by step, voice guided instructions as you hook it up to the victim. 

The device does the rest of the work, monitoring the heart rhythm and determining whether a shock is necessary. If the patient doesn’t need a shock, the AED will not provide one. Continue CPR until paramedics arrive.

How Do You Use a Defibrillator?

Operating an AED is simple, especially if you’ve familiarized yourself with the device before needing to use it. Press the “on” button and follow the steps provided by the computer’s voice. It will ask you to apply adhesive electrode pads to the victim’s bare chest and plug them into the defibrillator. Then, the device will automatically analyze the patient’s heart rhythm. Do not touch the patient during analysis, as it can create a false result.

If the defibrillator decides the patient’s heart is within a shockable rhythm, it will charge itself automatically and tell you when to press the shock button. Automatic versions will deliver a shock without you having to push a button. If no shock is required, or after one is performed, the device will ask you to check the patient’s breathing. If it is not normal, you must continue CPR. Many AEDs will also guide you through CPR compressions, letting you know how effective or ineffective they are and assisting you to perform more effective compressions.

What Is the Lifespan of a Defibrillator?

Currently, there is no definitive lifespan for AEDs. This is because they operate using replaceable parts. Typically, if the parts are still being manufactured, you can maintain and repair an AED without needing to replace the entire unit. 

AEDs will have a battery life of 2 to 7 years, and the pads are good for 2-5 years. AED USA has a program that monitors your AEDs and notifies you of any expiration dates that are approaching. 

At times, manufacturers will notify us about recalled AEDs. If yours is on the recall list, we offer trade in rebates that can assist you with the purchase of a new AED that will be more reliable and in good working condition.

The Department of the Army Technical Bulletin described AED life expectancy at about eight years. In general, if your device is no longer under warranty, repairing it can become too expensive, and it is best to replace the entire unit. If the manufacturer has stopped making batteries and pads for your model, replacement is essential.

How often should a defibrillator be serviced?

The batteries and pads for your AED need to be replaced every two to five years. However, inspections and other types of maintenance must occur as often as daily to ensure your life-saving device remains in working order. Whoever oversees maintaining your organization’s AED should also be the one to track inventory and order supplies, follow up on maintenance issues, and possibly train and retrain your staff members to use the AEDs.

Daily maintenance is as simple as doing a quick visual inspection to ensure the status indicator light is green, which indicates it is in working order. If it is red, you’ll need to perform further maintenance. Once a month, perform the following inspections:

• Battery Test – If your model has a “test” button, simply press it. If it doesn’t have a battery test button, turn the device on. It is working correctly if it prompts you to apply the electrodes. Always store a backup battery with your AED, as the primary battery can lose charge quickly. To replace, remove the primary battery and insert the backup battery. Turn the device on to ensure it is working.
• Charge the Unit – Your AED should always be plugged in to keep the battery charged. If it isn’t plugged in during an inspection, begin charging immediately. This is especially true if your device isn’t used often.
• Data Card Test – If your model uses a data card to record information, ensure the installed card is functioning properly.
• Electrode Inspection – Sticky electrode pads should all be in sealed packages. Keep one adult set and one child set with your device and replace them if they pass their expiration date.
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• Stock Check – Check your supply stock. Ensure it includes packaged and unexpired electrodes, razors, gloves, alcohol prep pads, a small towel, and scissors.
• Visual Inspection – Perform an overall check to ensure the device is clean and shows no visible signs of damage.

Consider our AED management programs, AEDMD and AEDMD Plus, both of which take care of your AED readiness checks monthly via a text message sent you that contains a link you will click on that walks you through quick, two minute AED readiness checks. Also, data from each readiness check is stored in our database so that you are covered legally if the need ever arises to prove that you maintain your devices regularly.

How Do You Know When to Adjust a Pacemaker?

Patients who use pacemakers typically see their doctors every six months to one year, while those who use implantable defibrillators visit about every three months. Between visits, telephonic transmitters monitor the devices’ performance and note differences in heart rhythm, lead corrosion, low battery, or other malfunctions.

However, they can’t always pick up when a minor adjustment is necessary. For this reason, patients should be aware of symptoms to watch for. People who have internal heart devices should not experience dizziness or shortness of breath. Loss of consciousness can also occur. It is important to seek medical attention and receive a device adjustment right away if you or someone you know is experiencing these symptoms.

AED Laws and Regulations

Laws governing the use of AEDs vary by state with regards to training, AED placement, registration, and physician oversight. Florida was the first to enact these laws in the 1990s, and most states have followed suit. For example, California requires them in health spas and gyms.

Although placement requirements vary between states, the laws do tend to follow the same general principles. This includes who can possess the devices, who requires training, who must be notified if one is used, and how to maintain them. Good Samaritan immunity laws exist in every state, varying widely in structure, to protect people who use an AED in an emergency situation with the intent of helping a victim in distress from any civil liability lawsuits. The intention of these laws is to encourage bystanders to utilize AEDs with no fear of legal ramifications. 

If you don’t already have AEDs in your establishment, now is the time to purchase one and potentially save a life. When making a choice among the options, consider your state’s AED laws, how up-to-date the model is (the newer the model, the longer parts will be in production for it), who you’ll need to train on the device, the overall cost, where it will be stored, and the level of management and support the seller provides. An established company like AED USA can help you decide which device meets your needs and your budget. Contact us to learn more!