AED Site Assessment
An AED site assessment provides a rational process for determining the optimal quantity and placement locations of AEDs required to provide a timely response to a sudden cardiac arrest.
The American Heart Association recommends defibrillation within 3 to 5 minutes - ideally in less than three minutes. Every additional minute lowers the rate of successful resuscitation by 7 to 10 percent. To achieve a good response time, there must be enough AEDs in the right places, a clear communications pipeline, and enough people trained to respond quickly.
There are two general approaches in minimizing the response time. The first approach places emphasis on having many trained responders, thereby increasing the likelihood that a trained responder will be near an AED location and able to "grab and go" (as in the case of a continually staffed security station). The second approach emphasizes the strategic placement of additional devices minimizing the distance that fewer responders would travel to get the AED.
However, considering these two elements alone is not enough. When performing this assessment, you must consider all the steps that need to take place within the 3-5 minute window of survivability. These steps include:
- Recognizing the event as a cardiac emergency
- Communicating the emergency
- Activating the internal responders
- Retrieving the AED
- Responding to the victims location
- Attaching the AED and delivering the shock
Applying an AED and delivering the first shock takes roughly one minute. To meet a goal of less than 3 minutes from "drop to shock," that leaves 2 minutes to get an AED to the victim (for a security guard to grab an AED and run to the victim, or for a coworker to dash to get an AED and then dash back to the victim). Walking at a brisk pace, a person can cover about 300 feet per minute.
Communication systems within a facility will greatly impact the time to respond. In the event of a sudden cardiac arrest, how will bystanders alert both internal AED responders and external emergency medical system teams (police, fire, or paramedics) without delay? Precious time can be saved with automatic notification systems. Ideally, AEDs are stored in a monitored wall cabinet that automatically notifies building security or other designated responders when the cabinet is opened. While performing this assessment, be alert to potential wiring connections for monitored wall cabinets. Attempt to place AEDs near electric smoke detectors, fire alarm beacons, or fire alarm activators. You must also consider what type of wall cabinet will be used in the recommended placement locations. Recessed cabinets are not appropriate for many wall surfaces such as marble, stone, or steel. Architectural restrictions or policies within the facility may also influence what type of storage cabinets are most appropriate.
Secured areas can present special problems in terms of response time. Consider locating units within unsecured areas unless the likely responders can easily transcend security checkpoints. Alternately, personnel at the security check points can serve as members of the ERT. When security personnel are members of the ERT, internal policies must address whether security personnel can leave their post to respond to medical emergencies. If these alternative strategies are not feasible, then make sure that time measurements include the worst case delay the ERT will encounter when required to pass through a security check-point.
Special attention should be paid to areas where large numbers of people visit, work, or assemble, such as cafeterias, auditoriums, gymnasiums, sports facilities, shop floors, and offices. Other locations of concern are high-traffic areas such as hallways near restrooms, reception areas, and main entrances. Also consider places:
- that are harder for emergency medical system teams to reach (such as deep inside a facility, high in a tall building, inside secure areas or remote locations)
- where people may be subject to strenuous activity, including exercise
- with many older people, who are at higher risk for sudden cardiac arrest
- near hazards such as high voltage electricity
Once it is decided who will likely respond, what communications will be relied upon, and which areas to protect, you can determine the number of AEDs and their specific locations. There is not one simple formula that applies to all facilities. Walking the facility while carrying a stopwatch and a building diagram is the best way to determine the optimal number and placement of AEDs. Ideally, a "drop to shock" time of no longer than 3 minutes is desirable.
Consider locating AEDs so they are:
- highly visible, such as in wall mount brackets or glass cabinets on building walls in general view - similar to fire extinguishers
- near expected responders, such as in security vehicles or at a security or first aid station
- close to where the largest number of people spend their time
- tied into your communications system, either by automatically triggering a call to security or placed near telephones
- protected from tampering, theft or damage (recessed mounts and alarmed cabinets are available)
- accessible during all shifts or hours of operation
The availability of trained personnel greatly impacts the effectiveness of an AED program. Security, safety, fire, and medical personnel should be considered as the primary source of responders. Other "natural" responders include "Hall Monitors", "Floor Captains" or other personnel designated to assist or respond to various medical and non-medical emergencies. Finally, volunteer responders should be offered training. More personnel trained in a given facility increases the likelihood of a more timely and effective response. The goal of an AED program is to have multiple responders and multiple AEDs arrive at the scene of a medical emergency.
A FREE AED SITE ASSESSMENT is available in the greater Kansas City area. Contact us to schedule an appointment.
Headquartered in Shawnee, Kansas, Kansas City First Aid specializes in teaching First Aid, AED, and CPR classes in public and private onsite locations throughout the Kansas City, and surrounding areas.
Classes for individual healthcare providers, childcare provides, and lay rescuers are offered regularly at one of our local locations. Visit our Class Schedule web page for scheduled public course information, and online registration.
All of the courses are available, and can be scheduled privately, upon request, for your group. If you would like information on group training at your workplace, please visit our Onsite Training Webpage or contact our office at 913-980-5245.