ACLS Library: Lifesaving with Automated External Defibrillators

More than a quarter of a million Americans die from sudden cardiac arrest every year—that’s one every two minutes. Patients in sudden cardiac arrest are nonresponsive and are not breathing normally or at all. There may be no signs of circulation. More than 20,000 of those patients might be saved through use of a “chain of survival” including cardiopulmonary resuscitation (CPR) and the portable lifesaving device known as an automated external defibrillator (AED). AEDs allow trained non-medical personnel to deploy usage upon the collapse of a person who is not breathing, is unconscious and appears to be in sudden cardiac arrest. If persons are trained to use the AED like they are trained in CPR, broadly as first responders, the American Heart Association notes that up to 50,000 people might be saved each year. Legislators have encouraged accessibility in recent years, rather than adding regulations and restrictions regarding AED usage. Every state in the United States has enacted laws or has adopted regulations regarding defibrillator use, as of 2001.

History

Heart surgeon, Claude Beck, who developed CPR, successfully defibrillated a teenage boy after he went into cardiac arrest after surgery in 1947. Made by his friend, James Rand, the device had two spoon-like silver paddles and was used only in open-chest situations. Paul Zoll invented the first closed-chest unit in 1956. Irish physicians used the AED within an ambulance setting in 1966, and Oregon emergency medical technicians (EMTs) used the device without a doctor present for the first time in 1969. 

How AEDs Work

Automated external defibrillators work by detecting cardiac rhythm and are only indicated for, and intended to be used on, victims of sudden cardiac arrest. Should normal rhythm be interrupted through ventricular fibrillation or pulseless ventricular tachycardia, the AED can deliver an electrical shock to treat the arrhythmia. The Occupational Health and Safety Administration (OSHA) states that for every minute of defibrillator delay for sudden cardiac arrest, chances of survival diminish 7 to 10 percent. The Cardiac Arrest Survival Act of 2000 provides nationwide Good Samaritan protection exempting anyone using an AED to save someone’s life from liability (42 U.S.C. 238q).

AEDs are simple to use. If you are a trained responder who finds someone unconscious and not breathing normally or not breathing at all, the procedure for use is simple:

  • Assess scene for hazards.

  • Call 9-1-1.

  • Determine patient status: breathing, not breathing, level of consciousness.

  • Explain to the 9-1-1 operator that a person has collapsed. Tell the operator that an AED is there and that you know how to use it.

  • Place the AED next to the collapsed person’s shoulders.

  • Turn on the AED.

  • Follow the verbal and/or visual AED instructions.

Make sure that you stick around after the ambulance has taken the patient to the hospital so that any institutional reports may be accurately filled out, unless procedure dictates otherwise. AEDs are not meant to be used on patients less than 55 pounds or who are under age eight.

AED Plans

AED plans should spell out, in detail, institutional policy, authority and responsibility, locations, purchase and installation, maintenance and testing, registration and reporting, the institution’s medical emergency plan, training requisites and implementation along with training providers. All AED plans are federally required to have medical oversight by a physician familiar with its usage and sudden cardiac arrest. Home plans obviously will not have the same level of detail, as usage will likely be limited to those within the home. However, an AED plan should be discussed and/or written down so that all family members understand AED use and its repercussions. Public Access Defibrillation (PAD) programs promote accessibility and placement in casinos, airports, senior centers, health clubs and private homes. AEDs have been sold without a prescription since September 2004.

Costs and Accessibility

The costs for AEDs has reduced significantly, often less than $1000, enabling AEDs to be used even in home settings as technology has grown. Greater accessibility and training encourages greater success rates in saving lives. Still, it’s difficult to quantify and qualify statistical data into “rates of success.” Saving any number of lives, be it one or many, is thought to be a worthwhile investment, financially and morally. Still AED use, just like CPR administration, is highly dependent on each individual’s unique situation and response—survival rates outside of a hospital setting are still quite low either way—but well worth the time and investment to save any number of lives.

Remind me to take my ACLS/BLS/PALS later

Pacific Medical Training Course Acceptance Chart

We provide online emergency education services to customers throughout the United States and internationally. Our courses are based on current AHA guidelines as documented in the official training manuals, and have been successfully used by thousands of individual and commercial/government customers for both certification and recertification.

For a complete list of US states and cities where our courses are accepted, plus basic local health statistics, see the chart below.

West Pacific Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Washington Seattle 79.65 years 15th
Oregon Portland 79.04 years 10th
California Los Angeles San Diego San Jose San Francisco Long Beach Fresno Sacramento Oakland 80.4 years
Alaska 78.3 years 50th
Hawaii Honolulu 81.48 years 4th
West Mountain Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Arizona Phoenix Mesa Tucson 79.92 years 29th
Colorado Denver Colorado Springs 79.92 years 32nd
Idaho   79.21 years 19th
Montana 78.35 years 25th
Nevada Las Vegas 77.59 years 42nd
New Mexico Albuquerque 78.21 years 34th
Utah 80.08 years 7th
Wyoming 77.61 years 21st
West North Central Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Iowa 79.68 years 5th
Kansas Kansas City 78.41 years 26th
Nebraska Omaha 79.18 years 16th
North Dakota 80.10 years 12th
Minnesota Minneapolis 80.85 years 6th
Missouri 77.44 years 33rd
South Dakota 79.85 years 23rd
East North Central Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Illinois Chicago 78.86 years 28th
Indiana Indianapolis 77.71 years 38th
Michigan Detroit 77.89 years 30th
Ohio Cleveland Columbus 77.52 years 36th
Wisconsin Milwaukee 79.32 years 13th
Middle Atlantic Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
New Jersey 79.66 years 11th
New York New York City 80.36 years 18th
Pennsylvania Philadelphia 78.16 years 26th
New England Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Connecticut 80.18 years 21st
Maine 78.68 years 8th
Massachusetts Boston 80.10 years 5th
New Hampshire 79.90 years 2nd
Rhode Island 79.26 years 10th
Vermont 79.70 years 1st
West South Central Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Arkansas 76.09 years 47th
Louisiana New Orleans 75.39 years 49th
Oklahoma Tulsa Oklahoma City 75.60 years 3rd
Texas Houston Dallas El Paso San Antonio Arlington Austin Fort Worth 78.27 years 6th
East South Central Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Alabama 75.18 years 47th
Kentucky Louisville 76.19 years 43rd
Mississippi 74.81 years 50th
Tennessee Nashville Memphis 76.2 years 39th
South Atlantic Region
State Major Cities Average Life Expectancy National Health Ranking PMT Courses Accepted
Delaware 78.38 years 30th
Florida Miami Jacksonville 79.70 years 33rd
Georgia Atlanta 77.09 years 31st
Maryland Baltimore 78.09 years 22nd
North Carolina Charlotte 77.19 years 32nd
South Carolina 76.57 years 45th
Virginia Virginia Beach 78.53 years 20th
West Virgina 75.16 years 9th

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