Difference between hospital defibrillators and AEDs
What do you think of when you hear the word “defibrillator”? Is it an image of a TV doctor yelling “clear!” before their patient arches off the table as two shock pads do their work?
There is a lot wrong with how defibrillators are depicted in many TV shows and hospital dramas.
(For example, it’s impossible to use a defib to resuscitate a flatlined patient. A heart needs to demonstrate some activity in order for it to be shocked back into a regular pumping rhythm.)
These depictions may have contributed to bystander reluctance to use AEDs (automated external defibrillators). The use of AEDs in out-of-hospital cardiac arrest situations is unacceptably low, due in-part to bystanders not being prepared to use them even if one is available.
For example, a 2016 survey on the streets of Hong Kong found that while most (96.5 per cent) would help a victim of out-of-hospital cardiac arrest, less than one in every five people (18 per cent) would use an AED.
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Difference between hospital defibrillators and AEDs
A hospital defibrillator is an industrial-strength device designed to deliver a specific charge, and equipped with a range of diagnostic tools to monitor the heart performance of the person it’s hooked up to.
It requires a doctor to know how to use it the correct way to get the best outcome for the patient.
Public access defibrillators – AEDs – provide the power of a hospital defibrillator but in a much more simplified form, to allow it to be used by regular people.
Benefits include:
- Automating the operation (no switches or buttons).
- Deciding how big a shock is required.
- Voice prompts, reminding the user what they need to do.
- Tools to help with better CPR such as a metronome beep to make sure CPR is being administered at the correct rate.
- Infant mode, providing a safe option for small children.
- Instructions for use so you can figure it out without training.
These are the essential requirements for AEDs.
Barriers to AED use
Despite AEDs making defibrillation available to the public, the survival rate of out-of-hospital cardiac arrest remains as low as less than one per cent of cases worldwide.
Barriers to AED use include:
- Public access AEDs aren’t accessible – it may be too far away, locked in a cupboard, or stored in a place that is only accessible at certain times of day.
- The user is not trained in CPR or resuscitation, which slows down the chain of survival.
- The fear factor – the user holds back from using the device due to inexperience, unfamiliarity, reluctance to be responsible for the outcome etc.
- Cost; AEDs are very expensive for personal ownership.
Addressing these barriers could significantly improve the survivability of out-of-hospital cardiac arrest.
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Why do TV doctors yell “clear”?
While TV hospital shows use the moment for effect, it is in fact, a real thing.
The action serves two practical purposes in particular.
One, the doctor doesn’t want anyone touching the patient when a shock is administered. Any contact can cause the electrical charge to transfer through physical contact.
Two, it gives the attending team a moment to reset.
Unlike hospital defibrillators, AEDs are automatic, meaning they detect if and when a shock is required. They also deliver a voice prompt to stand clear of the patient prior to shock.
Knowing where your nearest AED is kept, is one of the best ways you can prepare to help in an emergency.
