University of Louisville Researchers Find Readiness of Public Access AEDs Alarmingly Low

University of Louisville Researchers Find Readiness of Public Access AEDs Alarmingly Low

LOUISVILLE, KY -- No national standards exist for the maintenance of automated external defibrillators (AEDs) and their registration with manufacturers, making these practices voluntary and highly variable. What the public may not realize is that when AEDs are not registered, there is a greater chance that they will fail when needed.

That's the finding of a study conducted by cardiologist Brad Sutton, MD, an assistant professor of medicine and assistant dean for health strategy and innovation at the University of Louisville School of Medicine. The group found that significant variability exists in how AEDs are registered and maintained and because of this variability, the true risk for failure remains unknown.

"We know that rapid bystander CPR and the appropriate use of AEDs increases survival rates for the more than 350,000 victims of sudden cardiac arrest in the United States each year," Sutton said. "However, we found that the percentage of public access AEDs that fail standardized testing is quite high, and the incidence of potentially life-threatening malfunction is likely underreported."

"Our data suggests that registering AEDs correlates with increased likelihood that the device will pass testing, and therefore, stand a greater chance of being operational if needed by someone having a cardiac arrest."

"Sudden cardiac arrest is a leading cause of death in the United States," Keisha Deonarine, senior director of community health for the American Heart Association in Kentuckiana, said. "The American Heart Association believes it is important to do a weekly or monthly visual inspection of AEDs to ensure they are in working order. It may be the difference between life and death."

About the research

The group assessed AEDs in public, non-hospital settings in four geographically distinct regions - Seattle, Suffolk County, N.Y., Central Illinois and Louisville. Each AED was tested according to manufacturer guidelines. A total of 322 AEDs at 190 unique sites were investigated.

The team found that more than one-fifth of the devices -- 21 percent -- failed at least one phase of testing. Five percent had expired batteries, failing to power on at all and rendering them useless in the case of sudden cardiac arrest.

At the same time, public access AEDs found in areas where there was a higher rate of registration were significantly more likely to pass testing. AED registration was high -- greater than 80 percent -- in both Seattle and Suffolk County, with zero battery failures found in Seattle and only 2 percent in Suffolk County.

By comparision, both Louisville and Central Illinois had lower rates of registration -- less than 25 percent -- and higher rates of test failure at 19.8 percent in Louisville and 38.2 percent in Central Illinois. Central Illinois also had the highest regional battery failure rate at 12.36 percent.

AED registration typically is handled the way it is with consumer products: The AED is registered with the vendor so the purchaser can be updated on potential recalls and advisories. There also is an industry built around AED maintenance, and many sites with AEDs outsource maintenance of the devices for a monthly fee. Sites with AEDs also can register the devices with some municipalities or other local authorities, but again, Sutton said, this varies greatly from region to region.

"Unfortunately, our data suggests that even when you find an AED in the time of need, it may not work," Sutton said. "These devices require routine upkeep in order to remain functional and ready. This is the major message that our elected officials and community members need to be aware of."

Sutton's research group was made up of Jamie Heimroth, Stuart Crawford and Erica Sutton, M.D., of UofL and Josh Matzke of Eureka College in Illinois. The team presented their findings in November at the American Heart Association Scientific Sessions.

"Our study was limited in that results depended upon the voluntary participation of sites with AEDs," he said. "Those sites that refused to participate in the study may represent yet additional potential device failures, and ultimately, additional potential loss of life."

SOURCE: University of Louisville

AEDServiceAmerica's picture
AEDServiceAmerica wrote 2 years 5 weeks ago

AED Maintenance and Management:

There are four areas that AED owners must concern themselves with regard to deploying and AED program. Those four areas are:

1. Medical Prescription
2. Medical Direction, Medical Oversight, Medical Authorization
3. AED/CPR training and certification.
4. Tracking of Equipment Expiration Dates and Responder Certification Exp. Dates.

In many states all of the above are required. In those states that do not require them, they are still considered best practices.

For purpose of this discussion I will limit my comments only to the "Tracking of Equipment" from the 4th point above:

1 Tracking of Equipment. (AED maintenance and management)

All AEDs have pads and batteries. Those pads and batteries need to be replaced periodically. An AED owner can simply set up an excel spread sheet to remind them when to change pads and batteries or use a free service such as to manage their AEDs and responder expiration dates.

47% of all AED failures can be avoided by properly maintaining and managing pads and batteries. One of the reasons why pad and batteries expire is simply because many AED owners are not aware they must change them. Many of the accounts that we now manage and maintain we often find have pads that are years past their expiration dates and batteries that are dead.

One of the reasons why clients don't know is, over the past decade the number of AEDs purchased done online has skyrocketed. Lets face it, there is great convenience purchasing an AED online however the great challenges is, the AED owner will not be able to receive the highest level of service they need and deserve. For that reason, I highly recommend (when possible) to purchase locally and make sure your selling agent is willing (as well as qualified) to provide a free, onsite AED training in-service. This should become a standard practice.

Part of that in-service training should address; "How to Manage and Maintain Your AED". this alone would dramatically reduce improper AED maintenance.

If you would like to know how to manage your specific AED, I highly recommend you view your specific manufacturers owners manual and users guide. It will provide specific maintenance recommendations for your AED. (If you need a copy for your specific model please email me). The reason why this is important is simply because IT IS ONLY THE documentation provided in the users guide and owners manual THAT MATTERS IN COURT.

If you have improperly managed your AED and something catastrophic occurs, you will NOT be able to use the argument, "the sales rep told me, yada, yada, yada". I have found many sales reps either do not know vital information or do not willingly sharing it with clients in fear of losing a sale.

If you ever have questions or concerns on how to properly implement, maintain and manage a compliant AED program, there are plenty of resources to help you do so. Reach out to one of the sources and find out how to not only buy a great AED but also how to manage and maintain the entire deployment

My best.


Douglas Clydesdale Comstock
169 Newgate Road
East Granby CT 06026
dc [at] AEDserviceAmerica [dot] com

National Onsite AED Maintenance and Management Solutions.

Bob Trenkamp's picture
Bob Trenkamp wrote 2 years 32 weeks ago

Motivation to maintain

(This is a re-wording of a similar, prior post. It wasn't as clear as I would have liked.)

I've been told by an attorney that you can reduce your exposure to successfully getting sued by being able to prove that you maintained your public-access AEDs in accordance with the manufacturer's instructions.

For a HeartSine samaritan AED, this is achieved by checking the blinking light on the front panel once a week and keeping a record of who checked it when and whether the light was blinking.

I've been able to get a few organizations to start their weekly checks by explaining to the management what the attorney told me.


Bob Trenkamp, President
Saving Lives In Chatham County

SCAFoundation's picture
SCAFoundation wrote 2 years 32 weeks ago

Thank you for your insights

This is helpful, Bob!

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