Automated External Defibrillators (AEDs) are portable medical devices that play a life-saving role in providing first aid to people experiencing cardiac arrest. In the United Kingdom, as well as worldwide, these defibrillators are increasingly being deployed in public spaces, businesses, schools, sports clubs, hospitality establishments, apartment buildings, and homes. This development reflects their proven utility and necessity. Understanding the operation, importance, and functionality of these defibrillator devices can mean the difference between life and death for someone who suddenly experiences cardiac arrest.
Utility of Defibrillators
Cardiac arrest is one of the leading causes of death worldwide. In the United Kingdom alone, approximately 30,000 people experience cardiac arrest outside the hospital annually. During cardiac arrest, the heart suddenly stops pumping, which means that the blood supply to vital organs such as the brain is interrupted. The lack of oxygen-rich blood causes irreversible brain damage after just 6 minutes and leads to death within 10 minutes if no action is taken.
Starting chest compressions immediately and deploying a defibrillator as quickly as possible can be vital in such cases. The device analyzes the victim’s heart rhythm and can administer an electric shock if necessary to restart the heart. This process, known as defibrillation, is the only way to restore a normal heart rhythm and resume blood circulation, dramatically increasing the victim’s chances of survival.
Necessity of Defibrillators
The necessity of defibrillators becomes clear when we consider the time factor. For every minute that passes after cardiac arrest without treatment, the victim’s chances of survival decrease by 7% to 10%. If no action is taken, the victim will die after 10 minutes. If circulatory arrest lasts more than 6 minutes, the chance of permanent (brain) damage increases dramatically. Therefore, rapid intervention is crucial.
Research shows that using a defibrillator within the first 3 to 5 minutes after cardiac arrest can increase the chance of survival to as much as 70%. In the United Kingdom, there is a growing network of defibrillators, partly thanks to initiatives such as The Circuit UK, a national defibrillator network that connects defibrillators to NHS ambulance services across the UK and calls on citizens to provide help in emergency situations.
What to do if you witness a cardiac arrest?
“First, the emergency number (999 in the United Kingdom) must be called. Then chest compressions must be started immediately. Bystanders can meanwhile retrieve the nearest defibrillator, or otherwise wait for the emergency responders who are automatically called via the 999 system and The Circuit UK network and bring the nearest defibrillator on their way. Chest compressions must be continued at all times until professional help arrives.
7- and 3-minute zones
In the United Kingdom, the target for the arrival of an emergency responder is within 7 minutes – hence the importance of 7-minute zones. This is in most cases faster than the arrival time of an ambulance in rural areas. The United Kingdom is working toward comprehensive coverage with these response zones, which could significantly improve the survival rate: in the UK, currently about 10% of people survive a cardiac arrest outside of hospital, close to the European average, but with improved defibrillator access and response times, this rate could be substantially improved.
By further increasing the density of defibrillators, the response zones can be further reduced. The optimum is reached with 3-minute zones, in which case 70% to 75% of all victims could survive cardiac arrest. This is why initiatives like The Circuit UK are so important for mapping and increasing public access to defibrillators across the country.
Ease of use
If there is a defibrillator in the immediate vicinity of the victim, it can be deployed directly, even before the first emergency responder or ambulance arrives. The ease of use of the defibrillator is crucial in all situations, but especially when none of the bystanders are trained. The official advice is always to start resuscitation immediately and use the defibrillator as soon as possible, even if professional help has not yet arrived. Every second counts, which is essential to increase the chances of survival.
Reliability
Self-tests of defibrillators are essential for the reliability of these life-saving devices. Modern defibrillators are equipped with automatic self-tests that regularly check the status of the battery, electrodes, and internal components. This ensures that the defibrillator is operational when needed, without manual intervention. Self-tests eliminate the risk of malfunctions at critical moments and ensure that the device is always ready for use.
Important to note is that there are significant differences between the self-test routines of defibrillators. It is of great importance that a defibrillator tests daily whether the electrode pads are still functional. To always be able to rely on the proper and error-free operation of the defibrillator, it is essential to choose a defibrillator with the best self-test routines in the market.
Purchase, operational lease, rental, or subscription?
When wanting to make a defibrillator available, there are various financial options available, such as buying a defibrillator, using an operational lease, renting a defibrillator, or taking out a defibrillator subscription. Each option has its own advantages and disadvantages.
Below we discuss the differences between these four possibilities.
1. Defibrillator Purchase
When purchasing a defibrillator, the device is paid for in full at once, after which ownership is immediately transferred to the buyer. This is the most traditional way to acquire a defibrillator. The advantages of this method are clear: the buyer is the immediate owner of the device and doesn’t have to worry about monthly costs or contracts. The device can be used as long as it is functional, and there are no additional costs except for maintenance, replacement of batteries, and electrodes.
However, the disadvantage of a defibrillator purchase is that the initial costs can be quite high. A defibrillator can cost several thousand pounds, which can be a significant investment for individuals and some smaller businesses or organizations. Moreover, the buyer is responsible for maintenance and regularly replacing parts, which brings additional costs, organizational burdens, and risks.
2. Defibrillator Operational Lease
With a defibrillator operational lease, the device is leased for a longer term, often between 5 and 8 years. During this period, the individual or organization pays a fixed monthly amount to use the device. At the end of the lease period, the defibrillator can be returned, renewed, or possibly purchased for a residual value.
One of the main advantages of operational lease is that the high initial costs are spread over a longer period, which can improve cash flow. In addition, maintenance and replacement of parts are often covered by the lease contract. This means that the leasing company is responsible for keeping the defibrillator up-to-date, which is a big advantage for many individuals or organizations.
The disadvantage of an operational lease is that you ultimately pay more than with direct purchase, especially if the lease period is long. Moreover, the device remains the property of the leasing company, which means that the individual or organization does not build up ownership in the device. Finally, the contract must be signed for the full duration of the contract at the start, meaning there is no flexibility.
3. Defibrillator Rental
The term “rental” can easily lead to confusion in the case of defibrillators. Often the term rental is used for contracts that are in fact operational leases.
The other form of rental is more flexible and for shorter periods. Defibrillator rental contracts can be concluded per day, week, or month, which makes this option attractive for individuals and organizations that only need the device temporarily, for example for events, excursions, or (organized) vacations.
An advantage of flexible defibrillator rental is the flexibility. An organization can quickly have a defibrillator available without committing to long-term contracts. In addition, maintenance and replacement are often included in the rental contract, which reduces the responsibility of the renter.
4. Defibrillator Subscription
A defibrillator subscription offers an all-in service where the device is delivered and fully maintained for a fixed monthly fee. This is an increasingly popular option for individuals, companies, and institutions because it removes virtually all concerns about the maintenance and continuity of the defibrillator. In addition to the device itself, a subscription also includes the replacement of electrodes and batteries, both for regular, biennial preventive maintenance, and in the case of use or a malfunction.
The biggest advantage of a defibrillator subscription is the complete relief from worry. The provider is responsible for maintaining, testing, and replacing the defibrillator, batteries, and electrode pads, which gives the individual or organization complete peace of mind. Additionally, the monthly costs are predictable and often lower than with rental or lease in the long term, especially since there are no extra costs for maintenance. Another important advantage is flexibility: often with a subscription, there is a minimum term of a few months. Defibrillator subscription providers use a biennial “door-to-door exchange system” for maintenance, which means no special service technicians in cars are needed for maintenance, contributing to less pollution and lower maintenance costs.
The disadvantage of a defibrillator subscription is that the individual or organization never becomes the owner of the device. This means that after years of payments, you have not built up any ownership.
The Future of Defibrillators
There is growing attention to circularity and sustainability in the production and management of defibrillators. Some companies are introducing models that are fully circular, meaning that all parts can be recycled or reused after use, or that the lifespan of the defibrillator can be extended. This not only contributes to environmental protection but can also reduce the costs of maintaining these devices.
With continuous technological innovations, an increasing focus on sustainability and worry-free solutions, defibrillators will play an even more important role in the healthcare system of the future.