The Argument for Better Access to AEDs

I recently took my very first First Aid course with CPR and AED certification for St. John’s ambulance and I was astounded to learn how effective Automatic External Defibrillators (AEDs) are at saving lives. In cases of cardiac arrest, an AED can double the rate of survival from an out-of-hospital cardiac arrest (Weisfeldt et. al.). In cases of cardiac arrest, every second counts. Defibrilation and CPR must be started as soon as possible to maximize the chances of survival and to maximize quality-of-life after a heart attack.

The most recent versions of AEDs are idiot-proof. You simply place the sticky pads on the follow the directions which are essentially put the pads on the casualties chest and press a couple of buttons. They can be used with little or no formal training. Furthermore, the risk of delivering an unwarranted shock is negligible since the systems are designed to only shock people with the two life threatening types of cardiac arrythmia.

Despite their life-saving efficacy, the American Heart Association only recommends that an AED be installed if their is a 1 in 5 chance per year that it may be used. Even as far back as 2003, at least one study found that this recommendation is far too restrictive (this study also included substantial training costs that authors believe may not be necessary).  Since 2003, costs have fallen solidifying the argument that AEDs should be placed in many public places.

Given the substantial benefit, why aren’t AEDs more available? There is little economic incentive for most heavily trafficked public spaces to have an AED. There is no responsibility for public organization to intervene in medical emergencies, and in many cases they may be worried about liability in the case that they misuse an AED. Consumers might decide to frequent public places and store that have AED access, but they don’t have the necessary information about the location and effectiveness of AEDs.

Overall, Canada and other governments should be looking into more ways to economically increase  the accessibility of AEDs. Government programs to increase AED access could greatly increase the survival rate of heart attacks in Canada. So far in Canada the government response has been limited. The federal government announced a $10 million program to provide AEDs at hockey rinks, but this ignores the multitude of other public places where AED access could save lives for relatively low cost. At the provincial level, only Manitoba has regulation requiring AEDs. Many major centres have AED programs, but rural areas – where EMS service is generally slower and AED access more valuable – lack the resources.