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Essay by: ISP091   

Where will the nearest AED be when you need it most? Automated external defibrillators (AEDs) must be installed in populous public places. The University of Washington contends that at least two hundred and fifty thousand deadly cardiac arrests occur outside of hospitals in the United States every year. A large percentage of these deaths are preventable if the people nearby during the cardiac arrest knew where to find an AED. Up to 70% of these cardiac arrests are of the variety that can be solved by defibrillation via AED. Issues surrounding the expansion of AED availability require discussion about what is an AED, the device’s significance during a suspected cardiac arrest, the ease of use for the operator, the benefits of AED-CPR resuscitation versus cardiopulmonary resuscitation (CPR) only, and the logistics of maintaining AED stations.

An AED is a battery powered device which delivers an electrical shock to a person in cardiac arrest or when the heart is not beating efficiently. This shock is delivered from adhesive pads on the chest when the device detects that the patient’s heart rhythm is irregular and requires defibrillation. Every minute that goes by when a cardiac arrest strikes decreases the person’s chances of survival by up to 10%. The physiologic damage as a section of the human body is deprived of essential blood flow is also exponentially worse as time passes during cardiac arrest. Average response time by emergency medical personnel is about 10 minutes though making civilians on the scene paramount to the person’s health.

There was a time when only trained healthcare professionals were trusted to use a defibrillator. However, modern AEDs are remarkably straightforward in that they have speakers listing off transparent instructions to the operator as well as visual cues. AED training is unnecessary as any bystander would be able to follow the directions automated by the device. If a cardiac arrest happens to a child, there is also pediatric AED sized shock pads (for ages 1-8) provided in AED sets. These deliver a smaller but more appropriate shock to the patient; however adult sized pads are still indicated if they are the only option. An AED may be simple in its process but it is also a more effective way to assist in the event of a suspected cardiac arrest.

An AED is able to restart the heart while CPR will only act as a temporary pump. A Harvard study showed that CPR-AED combination resuscitation had a survival rate more than 60% greater than CPR alone. An AED could give enough clarity to that responder who is uncertain about CPR technique to save a life. CPR on its own is also exhausting for single responder situations and technique worsens as the responder physically wears out. Even if a bystander knows CPR, they may not have the confidence or skill to perform it properly. The general public may not understand that cardiac arrest can occur to individuals of any age and health state. Of course in any medical emergency, the first and most important action is to call 911 for urgent emergency medical services though if possible this should be delegated to another person on the scene other than the AED operator. An AED is a machine but luckily they are easily maintained and should be installed to be easily accessible.

AEDs must be highly visible so that potential operators may find it in a stressful and clouded situation. The American Heart Association recommends that an AED be within a 3 minute distance from the patient. A child or wheelchair bound individual must also be able to reach the AED. If we were to provide AEDs to public locales, maintenance costs would not be an issue as the device has a long shelf life and the battery is easily checked for viability. Insurance companies and government agencies frequently provide financial subsidies for AED purchasers. Many states provide legal protection to the operator in the instance of providing defibrillation via AED.

The public needs to know the facts because legislation to expand AED availability must be demanded from our appointed representatives in government. In a study by resuscitation journal, 11.6% of businesses that owned an AED had used it in the last 12 months on a suspected cardiac arrest. By that percentage we can deduce that nearly thirty thousand lives can be saved yearly by the availability of a nearby AED. Logical locations for AED installation are schools, churches, parks, public transportation, athletic events, businesses, libraries, businesses, and homes. Publicly accessible AEDs are almost nonexistent compared to their need and worth. When deaths are preventable, it is our duty to fill in the gaps of the emergency response system. I hope you will remember to support AED availability before your need becomes immediate.

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