Successful use of AEDs by lay responders depends on an organized and practiced response with likely rescuers who are trained and equipped to recognize cardiac emergencies, activate internal (e.g., building alert) and external (Emergency Medical Services) emergency systems, and provide CPR and rapid defibrillation. Widespread implementation of lay rescuer community AED programs can greatly improve the odds of SCA survival. In fact, when bystanders use AEDs to treat SCA victims before EMS arrives, survival rates increase from 7% to 38%.

The critical elements of successful lay rescuer AED programs are:

• Enlisting oversight by a healthcare provider
• Developing a written medical emergency response plan
• Training anticipated rescuers in CPR and AED use
• Coordinating efforts with the local EMS system
• Conducting regular maintenance checks.
• Conducting regular SCA response drills.
• Monitoring quality improvement.

To ensure proper device maintenance, it’s important to identify the individuals who are responsible for this critical task. Devices should be checked regularly, using a checklist such as the one below.

AED Maintenance Checklist

• Conduct scheduled preventive maintenance checks, according to manufacturer’s recommendations.
• Confirm device placement, ensuring AEDs are where they are supposed to be, and that they are available for use by the public, not hidden from view or locked away.
• Confirm that signage clearly alerts the public to the location of AEDs.
• Confirm that batteries are installed and check the expiration date. Replace batteries as needed.
• Confirm availability of electrode pads and check the expiration date. Replace electrode pads as needed.
• Check the status/service indicator light.
• Inspect exterior components for cracks or other damage.
• Check supplies and replenish as needed (razor, towel, barrier device, scissors, extra battery, extra set of electrode pads).
• After a cardiac arrest occurs, get the device back in service as soon as possible.

What about device self-tests? All AEDs on the market today conduct self-tests to ensure readiness for use in case of an emergency. The frequency and scope of self-tests, however, varies by manufacturer. It’s important to become familiar with self-tests by reading owners’ manuals.

It’s also important to pay attention and act immediately when self-tests advise that maintenance (e.g., battery replacement) is required. Device beeps should not be ignored. This is the precise time to prevent potential device failures.

As helpful as device self-tests are, however, they do not replace regular maintenance checks. AEDs cannot save lives by themselves. Like other medical and safety devices, their effectiveness depends on human planning and intervention.

-Mary M. Newman, MS