According to research, out-of-hospital cardiac arrest (OHCA) is becoming a great challenge to human health. Many patients with no history of heart disease are experiencing cardiac arrest without any warning: there are approximately 55 cases of OHCA per 10,000 adults each year ^[1]. With the development and innovation of medical technology, various equipment is popping up in the market to meet daily emergency needs. AED devices (or AED boxes), as one of the many first-aid tools, have gradually become known to a wider public. How to improve the utilization and effectiveness of AEDs at the beginning of planning every AED project and AED installation?

Introduction and Importance of AEDs

An automated external defibrillator (AED) is one of the devices used to manage sudden cardiac arrest. Most cardiac arrests are caused by an irregular heart rhythm called ventricular fibrillation. Once ventricular fibrillation occurs, an extremely dangerous condition arises ¨C blood cannot be delivered efficiently to other body parts. Five minutes after the heart stops beating, the brain cells of the patient will begin to die and cause irreversible damage to the body. In this case, using an AED to shock the heart back into rhythm is one of the most effective resuscitation techniques to save a patient. As OHCA cases continue to rise, it is critical to equip AED devices in crowded places, such as parks, shopping malls, and stations.?

Things to consider before installing an AED box

Statistics show that if defibrillation is delayed, the chance of survival will decrease by 7-10% per minute ^[4], not to mention that there are few survival cases where defibrillation starts ten minutes later?^[3]. In some areas, medical professionals typically arrive on scene 8-12 minutes after a witness calls 911 ^[5]. In other words, waiting for a professional medical team to arrive on the scene may be too late. Therefore, the deployment strategy of an AED determines whether a cardiac arrest patient can be rescued in time or not. It also affects the success rate of resuscitation once the EMS (Emergency Medical Services) team arrives on the scene. An AED can only play its critical role when the potential users know where it is and how to access it quickly. Thus, AEDs should not be hidden, and the path to accessing AEDs should not be blocked. Here are a few suggestions for installing an AED box at the ideal location.

1. High-traffic areas

AEDs should be placed close to areas where they are most likely to be used - that is, areas where many people typically gather. Other factors include the number of potential SCA (or Sudden Cardiac Arrest) patients, the layout of the building, and the level of activity therein. To this point, SCA can be caused by excessive physical exertion, long hours of continuous work, etc., so it is also necessary to consider placing AEDs in areas where there is strenuous physical exercise. Examples of high-traffic areas with the above characteristics include:

• Large office buildings, conference centers
• Schools, stadiums, hotels
• GymnasiumsLarge restaurants, canteens
• Gathering places like temples, places of worship, etc.?

2. Accessible areas

In an emergency, bystanders, and staff need to find the AED immediately. For this reason, the AED must be placed in the most obvious places. Please follow these tips to avoid impeding the first aid process:

• Install your AED cabinet in a place where it will not be obstructed in any way. Operating instructions and precautions should be pasted on the cabinet. Provide multilingual instructions according to the actual situation to help people gain access to AEDs.
• Place all AEDs at a suitable height (AED handle height no higher than 48 inches), ensuring that anyone can reach it in an emergency.
• Make sure your staff can take the AED with one hand to speed up the response time.

3. Noticeable places

To avoid unnecessary waste of time, people should be able to spot AEDs at a glance when they arrive at designated places. Some ways to keep AED cabinets visible are listed below:

• Standard signs should be used to identify the location of the AED. For example, apply reflective arrows and labels marked ¡°Automated External Defibrillator¡± to make the AED easier to find. In addition, AEDs should be placed in common meeting points, such as entrances, receptions, elevators, doors, pillars, etc.
• ?Adopting Eye-catching colors is also an ideal means to attract people¡¯s attention. Yellow, white or green with red are the most common colors for AED boxes.
• Be sure to use AED boxes with safety protection. Many AED boxes have an alarm on the door that goes off when the AED is removed, alerting site staff and nearby passersby to provide necessary assistance.
• Apply AED boxes that can adapt to different temperatures. Though AEDs do not require any power supply, AED cabinets for storing AEDs should work perfectly in the local climate. Otherwise, the AEDs inside will be vulnerable to extreme temperatures in different weather, thus affecting their lifespan and performance. In areas where extreme climates will happen, the AED cabinets should be able to adjust the interior temperature to keep it proper for storing AEDs.

How to Operate an AED?

Another factor to consider is the application of AEDs. Thanks to advanced technology, untrained bystanders can now successfully use an AED with the help of the machine¡¯s voice prompts and step-by-step instructions. The following is a quick guide to operating an AED device in an emergency:

1. Turn on the device.
2. Apply the adhesive pad to the patient's exposed chest according to the instructions on the device¡¯s display.
3. Allow the AED to analyze the heart rhythm before delivering an electric shock. The AED can monitor the patient's ECG signal with AED pads to see if there is a viable, electrically stimulable rhythm.
4. If the AED gives a shockable voice cue, press the button to deliver the shock.
5. Perform cardiac resuscitation following the voice prompts. After you¡¯ve given CPR, the device will again analyze the patient's heart rhythm to determine if further shocks or CPR are needed.Never forget to call an ambulance as soon as possible before using the AED.

Conclusion

¡°Installing AEDs in your workplace can give you peace of mind and save lives.¡± Bob Risk, senior strategy and safety, health, and preparedness manager at Staples Business Advantage, wrote in the Automated External Defibrillators at Work, Safety & Health magazine in 2016.

Mindray¡¯s easy-to-use and easy-to-manage AEDs are suitable for all common SCA occurrences. For 30 years, Mindray has been committed to providing affordable, high-quality, advanced healthcare services to benefit more people. Mindray¡¯s uniquely designed products make them easy to use, even for first-time users with no experience in AED training.?

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Mindray offers AEDs that take the actual AED cabinet installation into account to help you improve AED availability and avoid the potential hazards of inaccessible AED situations. Learn more about the benefits of installing a Mindray AED on our website.

References

[1] The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Available at: https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-2773-2#Fig1 (Accessed: 10 May 2022)

[2] Recent advances and controversies in adult cardiopulmonary resuscitation. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600120/ (Accessed: 10 May 2022)

[3] Good-hearted people, Busca cardio-protected city: an evidence-based public access defibrillation project. Available at:? https://shc.amegroups.com/article/view/5101/html (Accessed: 10 May 2022)

[4] How Long Does Brain Activity Last After Cardiac Arrest? Available at: https://www.verywellhealth.com/brain-activity-after-cardiac-arrest-1298429 (Accessed: 10 May 2022)

[5] Recent advances and controversies in adult cardiopulmonary resuscitation. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600120/ (Accessed: 10 May 2022)