From the May 2018 issue of HealthCare Business News magazine

In recent years, legislation has come into effect that provides for stricter manufacturing of PADs to ensure better reliability. However, these laws do not account for the PADs that have already been purchased. Our findings support the notion that every PAD site needs to consistently maintain its device according to manufacturer guidelines, as well as appoint someone as a PAD supervisor who will be responsible for maintenance, training, and device registration.

Unfortunately, much like the variability in PAD maintenance, laws regarding public access defibrillators vary significantly from state to state. One study used American Heart Association guidelines of public access defibrillation to identify 13 critical elements each PAD program should have. These included targeted AED site placement to maximize use, ongoing basic life support and AED training of anticipated rescuers through an approved course, and maintenance and testing of the AED device to ensure continued functionality.


The study found that no state required all 13 PAD program elements, only 18 percent of states require at least 10 of the elements, and 31 percent require three or fewer elements. Additionally, all states provided some level of immunity to AED users and only 41 percent require medical oversight. Only 60 percent of states expressly require AED maintenance as outlined by the AED manufacturer, and 30 states require businesses or sites that obtained AEDs to register the device with the local EMS system. Finally, it is rare that states require public grade schools, private schools, and colleges to have at least one AED.

Achieving optimal outcomes for victims of OHCA is multi-factorial. Certainly, appropriate device maintenance and function play critical roles. So, too, does proper training, and retraining, of lay people to perform adequate CPR, feel comfortable using AEDs, and minimize operator error. Unfortunately, bystander intervention occurs only about 4-7 percent of the time. This results from a lack of awareness of nearby PADs and their purpose, as well as citizens being uncomfortable using a defibrillator.

The prevalence of PADs with non-functional or expired components is unacceptably high. In our functional survey of 190 sites, those that failed at least one phase of testing were generally unaware of the problem. In some instances these sites may not have functional PADs when called upon. De Luca et al. described reported AED failures in the MAUDE (Manufacturer and User Device Experience) Database between 1993 and 2008, finding that there were 40,787 reported failures, 1,284 (3 percent) of which resulted in a death.

May 2018 Magazine

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