TechNation reached out to several leading companies and experts for this roundtable article on AEDs and defibrillators. Participants sharing their insights are Avante Health Solutions Market Manager Brent Kramer, ReNew Biomedical Field Sales and Service Representative David Okeson and SakoMed CEO Matin Kondori.
Q: What are the basic functions or features every defibrillator/AED should have?
Kramer: It is recommended for AEDs to have visual and voice prompts with simple illustrations and instructions printed on the case. It needs to be very user friendly so that any non-professional can use it in a fast and efficient way. When evaluating defibrillators, it is important to understand where in the facility the device will be used. A crash cart unit may only need basic functionality in 3-lead ECG, AED and pacing. Whereas a defibrillator for EMS will need a fully loaded defibrillator to include, AED, ECG (3- or 5-lead), capnography, SpO2 and pacing.
Okeson: Two essential functions should be present with every AED. One, the AED should always be rescue-ready and in a place easily accessible. Each manufacturer offers features on their AEDs to assist in this function and a variety of other additional support. Second, an AED should always be easy to use and support the steps in the chain of survival taught in CPR class.
Kondori: The most important part on AEDs are delivering the right amount of energy. Also, being able to show the correct steps on AEDs is a good feature that can helps users (with minimum knowledge) to make sure they are in the right path to save lives. In order to make AEDs following the basic functions and features, AAMI and IEC standards are being used to help biomeds make the best decision on purchasing AEDs.
Q: What types of checks and regular maintenance do defibrillators/AEDs require?
Kramer: In a hospital setting, defibrillators need to be checked monthly for basic function. Then checks at 3, 6 and 12-month intervals each having an increasing number of intricacy of tests performed. AEDs require a monthly check of function, battery life and pad expiration date.
Okeson: All AEDs perform automated self-tests, some daily and some weekly, and recommend a visual inspection once per month. Depending on the location of the AED, there may be other local requirements. On the other hand, defibrillators require a manual daily self-check, and some newer units even assist with automated tests.
Kondori: All AEDs need to have a good life of battery and pads with alarm or visual check mark that helps users to be aware that the AED is operatable. Defibrillators also need to be PM/calibration every year from checking on cosmetic to make sure on energy output is accurate. If defibrillators come with other monitoring parameters, we also need to make sure that they are within accuracy range. Other than annually biomed PM/calibration, facility nurses or staff also need to check AEDs/defibrillators every day to make sure they are ready to save lives.
Q: What are the most important things to look for in a defibrillator/AED?
Kramer: The new PMA regulations are impacting which defibrillators and AEDs are able to be purchased and sold. It is critical for buyers to understand which units and accessories are FDA approved. One common functionality of AEDs for buyers is whether the unit is semi-automatic or fully automatic. Semi-automatic AEDs give the responder control over when the shock is delivered.
Okeson: It is very important to acquire a defibrillator/AED from a reputable source that will be able to service and support the product. You want to buy a defibrillator/AED that has accessories such as pads and batteries readily available on the market. A unit that has FDA PMA approval assures you will have the accessories and parts available as well as the support of the manufacturer.
Kondori: If we are considering a defibrillator by itself, we are looking at the accuracy of the delivered energy and the accuracy of separating shockable and non-shockable based on analyzing the ECG rhythm. Depending on where we are going to use the defibrillator, our choices vary considering weight, size and the monitoring parameters. For example, a defibrillator on crash cart is very different than a defibrillator used on an ambulances.
Q: How can a HTM professional extend the life of defibrillators/AEDs?
Kramer: Compared to other medical devices, defibrillators/AEDs are low maintenance and seldom have system errors. By simply performing the recommended maintenance interval checks such as electrical safety tests, preventative maintenance checks and up-to-date pads and accessories, your device is sure last.
Okeson: Annual preventative maintenance (PM) is the first step your HTM professional can perform to assure your units are working properly and are up to date with current software and potential future problems are addressed. Your HTM professional can also make you aware of any recall issues with your equipment.
Kondori: By performing on time PM and calibration and choosing the right service company to maintain and do the right service based on the manufacturer by a trained biomed, using the OEM/FDA-approved accessories and making sure to mount the AEDs safely in cabinets or using soft/hard carry cases to avoid any physical damages is highly recommended. SakoMed offers a 24-hour hotline service and training based on the manufacturer to avoid any high-cost repairs and keep defibrillators always ready to save lives.
Q: What else should TechNation readers know about defibrillators/AEDs?
Kramer: Defibrillators should stay plugged into an A/C outlet when not in use in order to keep the batteries charged to their fullest capacity. A daily system test should be performed and logged to avoid any unfortunate events when a defibrillator/AED is needed. Defibrillators should only be used by trained personnel, whereas AEDs can be used by any non-professional without training.
Okeson: AEDs and defibrillators are like any other piece of electronic equipment and have an end of life. Since AEDs are seldom used and usually out of sight, they are often forgotten. Know when your end-of-life is and budget for replacement equipment.
Kondori: Besides on time service, PM and calibration I recommend upgrading defibrillators and make sure you are following FDA guidelines. All our focus is to make sure our defibrillators are ready to save lives.