It has been mandated in most US states that AEDs should be placed in schools, health centers, day care facilities, offices, theatres, airports, trains, busses, malls and other public places. It is also highly recommended that an automated external defibrillator is present in all work environments. An AED should be present in all state-owned buildings and health clubs that have over 500 members.

Still, a recent survey done by Stapczynski has brought to light the fact that zones with a low population density (lower than 100 individuals per square mile) have hardly ever used and needed an automatic external defibrillator. Another study from Washington proved that there are some areas where the inhabitants are more prone to sudden cardiac arrests than others, and that there are areas where this type of incident is more frequent.

Out of 71,000 zones, the study has identified 172 where AEDs are most needed and used. This type of study may be very beneficial for all states, because it indicates where more AEDs should be placed. This should result in a wiser positioning of automated external defibrillators and may result in more survivors of sudden cardiac arrest. Another study has shown that more than 50% of the sudden cardiac arrest cases happen in public places.

Automated external defibrillator location

This is the reason why the AEDs should be located in crowded places with high public density, areas like stadiums, airports shopping malls, restaurants, hotels, theatres, schools and other closed places that do not have sufficient air - a fact that may initiate sudden cardiac arrest. In 1997, the American Airlines traveling company was the first one to carry an AED device on board during an Atlantic flight.

Recently, a new law was granted regarding on-board compulsory equipment. The FAA directives command the existence of an automated external defibrillator in every aircraft. The personnel of the aircraft should necessarily benefit of proper AED usage training. This rule is in fact the amendment to part 121 of the Aviation Medical Assistance Act of 1998. In some cities, police vehicles carry AED devices.

Most ambulances have an automated external defibrillator to allow Basic Life Support Personnel to give first aid when an AED is needed. In states such as Tennessee and many more American states, it is mandatory to carry an AED on every ambulance and first response trucks. AEDs may be kept at home as well. A home AED kit is essential for people who have history in sudden heart arrest or other heart conditions.

How to select and AED

When selecting AED equipment, you should be up to date with the present recommendations of the American Heart Association (AHA). These recommendations can be found in Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. These guidelines will indicate the best AED for your unit. Currently, biphasic waveform defibrillators are recommended. This is due to the fact that the biphasic defibrillators consume less energy compared to the monophasic waveform defibrillators.

The biphasic defibrillators save up to 150 Joules, and are considered to be even more effective and safer. In case there is a monophasic defibrillator already existent in a building, this should be used as long as it proves to be effective. Otherwise, most specialists agree that there is no big difference between the monophasic and the biphasic defibrillators except for the fact that the biphasic AEDs save energy and need less battery power.

Automated external defibrillator response time

The response time in case of a sudden cardiac arrest should be less than 4-6 minutes. It is a proven fact that the intervention must be immediate, and with each minute that passes after the occurrence of the sudden cardiac arrest, the chances of survival of the patient drop by 10%. It is actually recommended that the AED kit should be held at the entrance of the building and that it should be brought in maximum 2 minutes to the place of the incident.

The AEDs are most often red, yellow or green, so as to be easily detected in an emergency. It is very important that the response systems should have appropriate equipment. The AED may be used by anyone, usually by the person that first reacts to the incident, and therefore, the AED device and wiring system should be compatible with the plugs in the building or transportation unit.