Recent discussions
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Ryan Brown
Recommendation supports the evidence synthesis/state of the science.
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Uwe Kreimeier
Dear Janet, dear Gavin:
As stated in the draft paper vandalism as well as robbery of AEDs are rare. An organization´s investment into an AED takes into account the potential loss of that device, e.g. not returning it after use.
Therefore I suggest instead of preventing robbery by means of locking, to enable the localization of the AED through a built-in Airtag chip. To my mind this solution has the benefit - in addition to fighting robbery - to track the AED after use.
In the long term, this has the perspective to incorporate geographical tracking of the AED in existing software-driven solutions for alarm systems used by first aid responders and dispatch centers.
Additionally, such a solution should display the status of the AED, e.g. by labelling active devices “green” and used devices “red”.
Sincerely,
Uwe Kreimeier, M.D.
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Curtis Edmondson
This makes sense on the surface. If an AED is in a locked cabinet, then it will inevitably increase the time it takes to access the AED. I agree with the conclusions set forth in this study. AEDs should be as easily accessible as possible, and if they must be locked in a cabinet or other such device, the instructions should be very clear and easy to follow.
When people are in an emergency situation, they are not able to think critically or follow complicated instructions very well. If the only option to keep an AED in a location is to keep it locked up, that would be better than having no AED, but clear instructions for opening the cabinet should be kept locally and given to 911 call takers for that area.
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Darlene M Hutton
While I agree with your recommendations against locked cabinets, for all the reasons stated, I feel that there continues to be a knowledge gap in the training of health care providers on the use of AED. As a BLS and ACLS instructor for over 25 years, I have witnessed health care providers apply the AED to a patient with an unstable tachycardia with a pulse numerous times. Their rationale at the time of the training scenario is something along the lines of "I'll apply the pads just in case they require the AED". Having trained and certified many health care providers, I realized that they are not routinely aware of the nuances of AEDs, specifically when it comes to an AED differentiating between how patients can present when in ventricular tachycardia. Approximately half of the healthcare providers that I certify doing BLS do not realize or are not confident in their knowledge that the AED cannot differential between a pulseless VT and an unstable VT with a pulse.
It's understandable why healthcare providers might err on the side of caution with unstable tachycardia, but the misconception about AED use in such cases highlights a need for added education.
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Dorothy (Doreen) Igharo
I think it might be possible to tack and retrieve stolen AED but vandalized AED require to be replaced. “AEDs can be recovered through tracking devices (Page 2024 110227)”. It also depends on the setting itself, inner circle query. Who are those stealing and vandalizing the AED? There could be one or more inner circle of the community groups involve otherwise, who else? I know this was not mention though in the research evidence
I think education in form of community groups public awareness/campaigns may play a vital role on the use of AEDs prevent vandalism and theft (Brugada 2014 S57). Thus, focuses on the importance of AED in resuscitation process, the chances of victims to survive rely greatly on AED accessibility. Vandalized and stolen AED impede the chances of victim survival rate. Even when AED are in locked or unlocked cabinets, as per this research evidence it “revealed that theft and vandalism was seen in both locked and unlocked cabinets”. However, if the community setting policy is to locked up AEDs in cabinets, instructions to access the keys should be make clear
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Edward Mak
Agree.. Communities with a good PAD program are typically in areas where there is sufficient funding. There is already a demographic bias because most PAD locations are typically the well funding areas. PAD programs need to focused on deploying AEDs in areas where EMS arrivals are >10mins. Strong recommendations EMS to be involved in ANY PAD program deployment.
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Edward Mak
Agree.. Communities with a good PAD program are typically in areas where there is sufficient funding. There is already a demographic bias because most PAD locations are typically the well funding areas. PAD programs need to focused on deploying AEDs in areas where EMS arrivals are >10mins. Strong recommendations EMS to be involved in ANY PAD program deployment.
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Edward Mak
It's quite clear there is insufficient evidence to support the practice of using Head up CPR. Even if the evidence was slightly stronger, there is a practical/ application component one must consider.
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Lino Masotti
Locked vs Unlocked AEDs for Public - LINO MASOTTI. (Heart and Stroke Foundation (CANADA) Experienced Instructor/Instructor Trainer - 23 years)
AEDs have proven to save lives and there have been many success stories with PROMPT public AED intervention in a CA. The PROS of having AED CABINETS “unlocked” in the General Public - ready for use especially in areas of increased pedestrian traffic areas (malls, plazas/piazza, convention areas, arenas/stadiums… ) greatly out weighs the disadvantages in when emergency medical services are immediately called.
From personal experience, a major concern is that a significant number of AEDs in my community are improperly maintained, lacking a maintenance plan. When I teach out-of hospital resuscitation programs; as part of training, I ask students to locate their in house AED and on several occasions find low batteries, expired pads…
On one occasion, while I was teaching, a student became severely ill and after assessing the student, called 911, had a staff member go and retrieve AED “just in case of cardiac event ” - after EMS had taken the patient to hospital, I checked the unit with the staff - low batteries and expired AED pads. I think this is an issue that needs to be addressed with certain workplaces as I do my best to make sure that they are informed about the proper maintenance and offer them solutions on updating their AEDs - this isn’t my job, but I care about healthcare making our community safer.
PROS UNLOCKED
- Effortless public access
- Immediate bystander CPR/AED -improving overall survivor stats.
CONS UNLOCKED
- Theft
- Lack of maintenance plan/control
- Environment conditions
- Vandalism
LOCKED AED CABINETS
Recommendation in environments controlled by a specialized emergency response team trained in a variety of emergencies with a duty to respond.
Facilities may also have oxygen, trauma kits, emergency medicine.
My input on where I would have a locked access AED cabinet:
PROS LOCKED
CONTROLLED ACCESS, BETTER MAINTENANCE, OTHER EMERGENCY EQUIPMENT
- Civil/Commercial aircraft
- Public transportation
- Medical/Dental Offices
- Event First Aid Stations
CONS LOCKED
- AEDs are inaccessible
- Alarms scare individuals
- Delays: If a key is required, retrieving the AED takes valuable time.
In conclusion locked/unlocked AEDs involves weighing accessibility against security/maintenance concerns. Balancing these approaches optimizes both public access and readiness which they were ultimately meant for.
Hope this helps.
Keep up the excellent work!
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Lino Masotti
Locked vs Unlocked AEDs for Public - LINO MASOTTI. (Heart and Stroke Foundation (CANADA) Experienced Instructor/Instructor Trainer - 23 years)
AEDs have proven to save lives and there have been many success stories with PROMPT public AED intervention in a CA. The PROS of having AED CABINETS “unlocked” in the General Public - ready for use especially in areas of increased pedestrian traffic areas (malls, plazas/piazza, convention areas, arenas/stadiums… ) greatly out weighs the disadvantages in when emergency medical services are immediately called.
From personal experience, a major concern is that a significant number of AEDs in my community are improperly maintained, lacking a maintenance plan. When I teach out-of hospital resuscitation programs; as part of training, I ask students to locate their in house AED and on several occasions find low batteries, expired pads…
On one occasion, while I was teaching, a student became severely ill and after assessing the student, called 911, had a staff member go and retrieve AED “just in case of cardiac event ” - after EMS had taken the patient to hospital, I checked the unit with the staff - low batteries and expired AED pads. I think this is an issue that needs to be addressed with certain workplaces as I do my best to make sure that they are informed about the proper maintenance and offer them solutions on updating their AEDs - this isn’t my job, but I care about healthcare making our community safer.
PROS UNLOCKED
- Effortless public access
- Immediate bystander CPR/AED -improving overall survivor stats.
CONS UNLOCKED
- Theft
- Lack of maintenance plan/control
- Environment conditions
- Vandalism
LOCKED AED CABINETS
Recommendation in environments controlled by a specialized emergency response team trained in a variety of emergencies with a duty to respond.
Facilities may also have oxygen, trauma kits, emergency medicine.
My input on where I would have a locked access AED cabinet:
PROS LOCKED
CONTROLLED ACCESS, BETTER MAINTENANCE, OTHER EMERGENCY EQUIPMENT
- Civil/Commercial aircraft
- Public transportation
- Medical/Dental Offices
- Event First Aid Stations
CONS LOCKED
- AEDs are inaccessible
- Alarms scare individuals
- Delays: If a key is required, retrieving the AED takes valuable time.
In conclusion locked/unlocked AEDs involves weighing accessibility against security/maintenance concerns. Balancing these approaches optimizes both public access and readiness which they were ultimately meant for.
Hope this information helps. Keep up the excellent work.