When cardiac arrest happens, public AEDs are often the first line of defense in saving a life — but researchers have found that roughly one in five of these devices are not in full working order.

Currently there are no national standards for the maintenance of automated external defibrillators and Dr. Brad Sutton of the University of Louisville School of Medicine thinks that’s a major problem. He and his research team discovered a significant amount of variability in how AEDs are registered and maintained and as a result, the true risk for failure is unknown.

“Our study has helped to highlight a problem that is common sense in some respects but is much more widespread and potentially detrimental than I think has ever been reported,” Sutton, assistant dean for health strategy and innovation and clinical cardiac electrophysiologist at the university, told HCB News.
The research team evaluated 322 AEDs in 190 public, non-hospital settings in four geographically distinct regions: Seattle, Suffolk County, NY, Central Illinois and Louisville.

They found that 21 percent of the devices failed at least one phase of testing. In addition, five percent had expired batteries and failed to power on at all, rendering them useless in the incident of sudden cardiac arrest.

Public access AEDs located in areas where there was a higher rate of registration were significantly more likely to pass testing. In Seattle and Suffolk County, the rate of AED registration was greater than 80 percent, with no battery failure found in Seattle and only two percent in Suffolk County.

Louisville and Central Illinois had registration rates of less than 25 percent and test failure rates of 19.8 percent and 38.2 percent, respectively. Central Illinois also had the highest regional battery failure rate at about 12 percent.

“There are municipal areas like Seattle where a community gets together and says they are going to make sudden cardiac arrest a priority and the AED readiness becomes part of their program,” said Sutton. “But those are hit and miss and many of our communities don’t have that level of investment and engagement around that issue.”

The AED is typically registered with the vendor so the purchaser can be updated on potential recalls and advisories. But in many cases the AEDs are sold through a distributor instead of directly from the manufacturer, Sutton explained.

The manufacturers make the guidelines available at the time of purchase and online as to how the AEDs should be maintained, but no legislative consensus has been reached on whether it should be enforced on a state or national level.

“You see AEDs in airports, casinos, churches and sports facilities,” said Sutton. “Many times whoever champions getting the AED in the first place at that organization is either transitioned or moves away. People see it on the wall but don’t recognize it or think about it and so the maintenance goes completely unattended to.”

He believes that elected officials and community members should be made aware that AEDs need routine upkeep in order to be functional and ready to serve their function as lifesaving emergency devices.

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