Recent discussions
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Andrew Benson
I would strongly advise against having locked cabinets in the setting of public access defibrillators. The program I was associated with for 25 years supported in excess of 400 public access defibrillators and never had an incident of vandalism or theft. I will qualify the statement that our experience was almost exclusively with indoor AEDs. we have limited experience with AEDs place in outdoor public settings.
As has been well established, ready access to defibrillators enhance the outcome of victims of cardiac arrest. Our own experiences would indicate better than a 50% survival to discharge when a PAD device is used.
I believe several aspects need to be balanced: ownership and cost of the AED will at times heighten the concern and implications for theft and vandalism which can be offset by support of a program (and back up devices should it occur); vs the public perception of a locked device suggesting it is not for everyone's use, regardless of training and may create inherent delays in access and application of the AED as well potential for damage to the case and or the individual trying to access the AED.
We need to ensure everyone has access to these potentially life saving devices as well as educating the public about their availability and need.
Thanks for the opportunity
Andy Benson
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Wendy Bissett
Excellent review - thanks for sharing And providing the opportunity for feedback. I think a simple cabinet with an alarm triggered door (like some fire extinguishers) would be enough of a deterrent to theft but not delay access.
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Andrew Benson
I would strongly advise against having locked cabinets in the setting of public access defibrillators. The program I was associated with for 25 years supported in excess of 400 public access defibrillators and never had an incident of vandalism or theft. I will qualify the statement that our experience was almost exclusively with indoor AEDs. we have limited experience with AEDs place in outdoor public settings.
As has been well established, ready access to defibrillators enhance the outcome of victims of cardiac arrest. Our own experiences would indicate better than a 50% survival to discharge when a PAD device is used.
I believe several aspects need to be balanced: ownership and cost of the AED will at times heighten the concern and implications for theft and vandalism which can be offset by support of a program (and back up devices should it occur); vs the public perception of a locked device suggesting it is not for everyone's use, regardless of training and may create inherent delays in access and application of the AED as well potential for damage to the case and or the individual trying to access the AED.
We need to ensure everyone has access to these potentially life saving devices as well as educating the public about their availability and need.
Thanks for the opportunity
Andy Benson
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Mike Janczyszyn
This is an interesting topic to explore. Being a public access to defibrillator coordinator, I deal with questions about this all the time. We unofficially keep track of our 24/7 cabinets that are unlocked.
While not having accessed the research, I have concerns that thefts might be underreported as they are here. They rarely get reported to police and they just end up not buying another AED and leaving that area empty, or they replace it at a cost to themselves.I'm a little confused with the search criteria; one says it ended in May 2024 while the other paragraph said June 2024. Petty difference, I know…
I'd be curious about the differences between the locked cabinets as well. Some would have a physical key vs. a keypad. We have just introduced a phone application called GoodSAM that would give someone the keypad number if someone called 911. Even in that instance, I would still see a potential delay in getting the code to the right person. The app holder would have it but maybe it's needed sooner. The call-taker may be busy with other things to provide the code right away as well; or maybe all the codes are the same; just providing a deterrent.
Another interesting avenue would be the education part. It is mentioned once in there. More education would hope to receive less theft (that's the hope anyway).
Very excited to see further reviews and research on this and hoping Canada can be part of one such study.
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Suzanne Vanderlip
I agree with the challenges outside healthcare and EMS stations related to locked boxes that contain an AED. In this day and age of easy access to cell phones the public can call 911 or (other emergency number of the area or country) to ensure that EMS response is activated. However with the encouragement of training the public in bystander CPR and early defibrillation it is important to have access to an AED. The idea of tracking the AEDs related to theft is an option as well.
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Sherry Campbell
The format in which this article has been set up is very clear and easy to read.
An area that was not discuss was the demographic location of the AEDs - does identify community (not in a building), but what area in the community are these AEDs located? Outside a shopping plaza, busy intersection, etc.? What country - In Canada - USA - Europe?
Thank you for allowing me to review.
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Peter Mertins
I appreciate the global perspective and treatment recommendations that are listed in this article regarding immediate care for amputations and avulsions.
Primary care for a patient/victim experiencing life threatening bleeding should always be stressed when referring to this topic. Also, please add that the wrapped body part , after being placed in the airtight bag (cooling container) be labeled with the time that the part was cared for.
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Brenda Brandt
Working and Living in rural Saskatchewan can sometimes be a challenge. Our town of approx 300 people and surrounding community of another 300 people have access to 3 AEDs The unfortunate part is where they are located - in the school, community hall and skating rink/swimming pool {dependent on the season} These are great locations provided the emergency happens during school hours, when the rink or pool are open or if there is a community function on at the hall.
I know the community does not want free access to the building housing the AEDs but they cannot be accessed at any other times virtually rendering them useless. I am not sure what a good place with available access would be. People being people also do inappropriate things - I have heard of incidents where intoxicated persons thought it might be fun to try out the AED and of course damaged it. I have used an AED in my EMS career with positive results so know how valuable and timely there uses is. Good luck on finding an appropriate way to access and utilize this lifesaving resource
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Dorothy (Doreen) Igharo
Base on this research review outcome, the recommended treatment remains unchanged since 2021. It proposes against the use of head-up CPR r/t very-low-certainty evidence. It also suggests that the usefulness of head-up CPR during be assessed in clinical research or trial initiatives-very-low-certainty evidence and weak recommendation. As per this review research outcome, there is no substantial evidence that the head-up CPR bundle is connected with better neurological and survival outcomes. This research review outcome did point out that the “significant outcome of ROSC, the observational study by pepe et al. an augmented rate of resuscitation success as seen in hospital arrival with continued spontaneous circulation whereby the Moore and the Bachista studies both indicated that ROSC were not statistically significant difference between the head-UP CPR group and the conventional CPR groups”
Therefore, I think that further research is required to determine the effects of head-Up CPR on Neurological and survival outcomes
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Peter Mertins
I agree with the findings of the task force regarding Head Up CPR.
I agree that more research on this area is warranted before it becomes a treatment recommendation in BLS and ACLS. After having reviewed some of the references, I have a better understanding of how CPR compressions increases ICP and how Head Up CPR along with ACD along with ITD may benefit reduced ICP pressures from brain to heart and increase cerebral perfusion as well. I can understand how Head up CPR would have to be implemented along with ITD and ACDs and with that further training and cost of these tools and training would be rather extensive and perhaps not possible for some regions of care Further research and study into this area may indeed prove effective for its use, but I would argue to continue with traditional CPR compressions maintaining adequate rate, depth, and recoil while using a compression feedback device if available Also the use of a CPR coach is ideal to monitor the compressions and give feedback as needed, or even to recommend that compressor roles be switched(team CPR).