Public access to defibrillation (PAD) means making AEDs available in public and/or private places where large numbers of people gather or people who are at high risk for heart attacks live.
The AHA strongly advocates that all EMS first-response vehicles and ambulances be equipped with an AED or another defibrillation device (semiautomatic or manual defibrillator). The AHA also supports placing AEDs in targeted public areas such as sports arenas, gated communities, office complexes, doctor's offices, shopping malls, etc. When AEDs are placed in a community, the AHA strongly encourages that they be part of a defibrillation program in which:
It's important for the local EMS system to know where AEDs are located in the community. In the event of a sudden cardiac arrest emergency, the 9-1-1 dispatcher will know if an AED is on the premises and will be able to notify the EMS system as well as the responders already on the scene.
This is a quality control mechanism. The licensed physician or medical authority will ensure that all designated responders are properly trained and that the AED is properly maintained.
Early CPR is an integral part of providing lifesaving aid to people suffering sudden cardiac arrest. The ventilation and compression skills learned in a CPR class help to circulate oxygen-rich blood to the brain. After delivering a series of three electric shocks, the typical AED will prompt the operator to continue CPR while the device continues to analyze the patient.
An AED operator must know how to recognize the signs of a sudden cardiac arrest, when to activate the EMS system, and how to do CPR. It's also important for operators to receive formal training on the AED model they will use so that they become familiar with the device and are able to successfully operate it in an emergency. Training also teaches the operator how to avoid potentially hazardous situations.
AEDs are manufactured and sold under guidelines approved by the Food and Drug Administration. Current FDA rules require someone who purchases an AED to present a physician's prescription for the device.
Your local EMS system can help you find out about local and state protocols and requirements for AED training and use.
If the person is a trained and licensed medical first responder (MFR), an established standard of care is outlined in the law, and those operating within these guidelines are protected under these laws. These same guidelines pertain to the personnel in your EMS system. If they are not trained and licensed MFRs, check the state laws to determine if lay rescuers are given limited liability immunity. If not, they may not be protected from litigation. Agencies should seek legal counsel before implementing a defibrillation program.
The price of an AED varies by make and model. Most AEDs cost around $3000.
Any person or entity wanting to buy an AED must first get a prescription from a physician. The AED should be placed in use within a defibrillation program that includes these elements:
The AHA does not recommend a specific device. All AED models have similar features, but the slight differences allow them to meet a variety of needs. The AHA encourages potential buyers to consider all models and make a selection based on the buyer's particular needs. The local EMS system can help you with this decision.
The American Heart Association offers CPR and AED training through Community Training Centers (CTCs). To locate a Training Center, call your nearest AHA office or ECC consultant.
The AHA has developed a new Heartsaver AED Course that integrates CPR and AED training. The course is 3½ to 4 hours long.
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