Closest Is "Best"
There are many AED products on the market. The "best" AED is the one that is closest in the event of Sudden Cardiac Arrest (SCA) [1]. No AED has been proven to be scientifically superior to the others and, because of the nature of the product, it is unlikely that there will ever be a Consumer Reports-type rating of these medical devices.
All AEDs Are FDA-Approved
There are eight manufacturers [2] making AEDs for use in the United States. Each device has been thoroughly tested and approved by the Food and Drug Administration.
What follows are some suggestions and factors that may guide you in your search for an AED for use by your school, youth sports club, business or facility. After you have reviewed this list, click here [3] for a side-by-side comparison of several of the AEDs that are available in the United States.
Ask For Advice
There are a number of sources to which you can turn for information and advice about AEDs:
Medical Director. Your program will require medical direction [4]. Ask your physician whether he or she recommends one model over another and why.
Emergency Medical Services (EMS) [5]. Ask your local ambulance squad the same question. Often members of this group will have experience with AEDs in other facilities and can comment on their strengths and weaknesses.
Organizations Similar To Yours. Find out what AEDs have been selected by other youth sports programs, organizations or businesses similar to yours in your area, why they made their selection, and whether they are satisfied with their choice.
If you are choosing a second, third or fourth AED for your facility/program/organization, it is generally a good idea to buy the same model as you already have, unless there is some problem with it or there is some compelling reason to switch. There is a real advantage to having all AEDs your organization uses be the same model.
Consider Features
Does the AED alert the rescuer if a second shock is required? A patent's heart will frequently lapse back into a life-threatening arrhythmia [1] even after a successful shock, a phenomenon called refibrillation. A timely response to refibrillation is vital, as every minute of delay reduces the chance of survival [6] by approximately 7 to 10%. Look for an AED that not only provides continuous monitoring of the patient's heart rhythm, but alerts the responder quickly if a shockable rhythm is detected.
Does the AED have a system to accurately detect life-threatening arrhythmias? While all AEDs have a system to detect life-threatening arrhythmias and deliver therapy, not all systems are the same. Manufacturers should meet or exceed performance requirements and standards established by the Association Advancement of Medical Instrumentation (AAMI) and the American Heart Association (AHA). To reduce the possibility of inappropriate delivery of a shock, look for an AED that provides an exceptional level of accuracy.
Be Wary Of Sales Hype
The one he is selling is always the best. It is unlikely that any single distributor sells every model of AED available. It is even more unlikely that a sales rep. for any distributor will conclude that an AED he does not sell is superior to one he does.
Take criticisms of competitors' AEDs with a grain of salt. Too often, sales reps focus more on what is wrong with a competitor's AED than the real strengths of their own. Often their criticism of the competition is exaggerated or simply wrong. Take good notes and, when the competition shows up, ask about the weaknesses of their AED that the competitor's sales rep. #1 pointed out to you. You will get an answer, but don't be surprised if sales rep. #2 counters with weaknesses in the model being sold by the first guy. It's the nature of the beast. Be critical of anything you are told especially if it isn't backed up in writing.
Consider Placement
Stationary Or Moved Around A Lot? Any AED will do well as long as it is kept in a stationary location in a heated building. If it's moved in and out of the trunk of a car so that it is available at a soccer complex, for instance, you need to be concerned with its durability and its ability to withstand some abuse. None of them will hold up if they are permanently stored in excessively hot or cold areas during all seasons of the year.
Is Noise A Problem? AEDs placed in facilities where noise is a problem (or might be used by people with hearing impairments) should provide both visual and verbal prompts. In noisy areas, the rescuer can rely on visual directions. In addition, the clarity and loudness of the voice prompts differs from one unit to the next. If possible, try to hear a sample of each unit's voice prompts to determine which would work better in a noisy environment.
Don't Place Too Much Emphasis On Operating Costs
Check warranties to make sure that if your AED malfunctions, it will be repaired promptly and at no cost, and that a loaner will be provided.
Expensive maintenance programs are not required for AEDs in public access defibrillation programs. However, such plans are recommended for AEDs that see heavy use.
Claims that replacement batteries and electrodes are expensive need to be put into perspective. Most AEDs will be used so infrequently that the cost of replacing these items is inconsequential.
Consider Group Targeted For Protection
Can the AED treat children? Every AED will work with adults. Although relatively rare, SCA does strike children [7] , either as a result of blunt trauma to the chest [1], respiratory arrest, or congenital heart disease.
Consider Ease-of-Use And Training Requirements
Unambiguous Voice Commands. An AED must help the trained rescuer defibrillate a victim as quickly and calmly as possible. Any confusion - ambiguous pad-placement icons, slow device response, or unclear voice commands - has the potential to slow down the process. When choosing an AED, look for one that initiates each phase of the resuscitation with unambiguous voice commands.
Fewer Steps Are Better. The fewer steps that must be followed, the faster a shock can be delivered. Try each model out to see whether the number of prompts 'feels' right - enough to provide guidance, but not so many as to bog a rescue down. Will the AED help responders use it effectively in an emergency situation? Additional physical steps can also slow response time in an emergency. Consider AEDs that have their pads pre-connected and those that do not have any lids or moving parts that add additional steps to the rescue.
Less Training Required Is Better. The less training [8] a rescuer needs to receive, the more likely that rescuer is to recall the training when an emergency occurs. In fact, it has been shown that even people with no training can intuitively use some AEDs effectively.
Consider Ease Of Maintenance
Automatic Self-Tests. Some AEDs require manual testing with external devices and periodic calibration, in some cases performed by factory service personnel. This type of maintenance can be time-consuming and may require costly service contracts. Some AEDs conduct their own self-test functions and can tell you when certain problems occur, such as a low or depleted battery. Many AEDs automatically initiate daily self-readiness checks and continuously display their readiness for use. These checks offer assurance that the unit will perform when someone's life is on the line. Look for an AED with these features. That way, you avoid the added expense and inconvenience of taking the unit out of active duty on a routine basis.
Manual Tests. Periodically, the AED should be manually checked. This may only mean that someone checks to see that its 'Ready' signal is displayed and that the electrodes and battery are present and are not beyond their expiration dates. Models differ on how easily these tests can be completed.
Only One "Wrong Choice": Not Buying One
No one model is likely to come out on top in every category. The only wrong choice you can make is not to buy an AED after you have determined that your facility needs one.
* The guidelines provided here are designed to help you select an AED for a public access defibrillation program. In such a program, the device that you ultimately select will be used infrequently, if ever. Our suggestions may not apply to those selecting AEDs for environments where the AED will be used weekly or monthly.
Links:
[1] https://mail.momsteam.com/node/354
[2] https://mail.momsteam.com/node/359
[3] https://mail.momsteam.com/359
[4] https://mail.momsteam.com/node/357
[5] https://mail.momsteam.com/node/387
[6] https://mail.momsteam.com/node/388
[7] https://mail.momsteam.com/node/370
[8] https://mail.momsteam.com/node/284
[9] https://mail.momsteam.com/users/glenn-laub