AED Automated External Defibrillation in Basic Life Support
The importance of defibrillation has been well established as part of overall resuscitation,
along with effective cardiopulmonary resuscitation (CPR). An Automated External
Defibrillator (AED) must only be used for persons who are unresponsive and not breathing
normally. CPR must be continued until the AED is turned on and pads attached. The rescuer should then follow the AED prompts.
The time to defibrillation is a key factor that influences survival. For every minute
defibrillation is delayed, there is approximately 10% reduction in survival if the victim is in
cardiac arrest due to Ventricular Fibrillation (VF). 1 CPR alone will not save a person in VF.
Hence a defibrillator should be applied to the person in need as soon as it becomes available so that a shock can be delivered if necessary.
The development of AEDs has made defibrillation part of basic life support. AEDs can
accurately identify the cardiac rhythm as “shockable” or “non shockable”.
2 Which rescuers should use an AED?
AED use should not be restricted to trained personnel. Allowing the use of AEDs by
individuals without prior formal training can be beneficial and may be life saving. Since even
brief training improves performance (e.g. speed of use, correct pad placement), it is
recommended that training in the use of AEDs (as a part of BLS) be provided. 2,3 [Class A;
LOE II, III-1, III-2, IV, extrapolated evidence] The use of AEDs by trained lay and professional responders is recommended to increase
survival rates in those who have cardiac arrest.2
3 Public Access to AEDs
Implementation of AED programs in public settings should be based on evidence of
effectiveness in similar settings. Because population (e.g. rates of witnessed arrest) and
program (e.g. response time) characteristics affect survival, when implementing an AED
program, community and program leaders should consider factors such as location,
development of a team with a responsibility for monitoring and maintaining the devices,
training and retraining programs for those who are likely to use the AED, coordination with the local Emergency Services, and identification of a group of paid or volunteer individuals who are committed to using the AED on those who are in cardiac arrest.2 [Class A; LOE I, II,
III-1, III-2, III-3, IV] Deployment of home AEDs for high-risk individuals who do not have an implantable
cardioverter defibrillator (ICD) is safe and feasible, and may be considered on an individual basis, but has not been shown to change overall survival rates. 2 [Class A; LOE 2, 3] Use of
AEDs in public settings (airports, casinos, sports facilities, etc.) where witnessed cardiac
arrest is likely to occur can be useful if an effective response plan is in place. 2 An AED can
and should be used on pregnant women who are in cardiac arrest.