In the realm of Sudden Cardiac Arrest, the promise of the Automated External Defibrillator (AED) shines bright. This remarkable device, which can deliver a life-saving electric shock to restart a heart in Sudden Cardiac Arrest (SCA), has become a beacon of hope. 

If you were to graph the number of AEDs distributed over time, you’d see an increasing steep line climbing up and to the right. People are getting the message that AEDs have the power to save a life. Paradoxically, if you were to graph the survival rate from out-of-hospital Sudden Cardiac Arrest over the same period, you’d see a mostly flattish line hovering around 10% survival. I’ve included an illustrative graph to visualize this point. The increasing space between AED growth and the Sudden Cardiac Arrest survival rate is what I call The AED Paradox.



The Crux of the Paradox

Something is missing. With more AEDs available, why haven’t we seen a dramatic improvement in survival rates? Logically, if an electric shock is the solution to SCA, and AEDs provide this electric shock, it would stand to reason that more AEDs would result in more lives saved. Yet, out-of-hospital survival rates have remained puzzlingly flat*. This stark reality compels us to ask: Are AEDs alone sufficient?


AEDs Are Just the First Step

The answer, as the gap forcefully points out, is NO! It’s true that AEDs are essential, and we need more of them, but AEDs are only one piece of a larger, intricate puzzle that requires a multi-faceted approach to enhance Sudden Cardiac Arrest survival. The presence of an AED in every corner of a school, home, office building, airport, or sports arena is an excellent starting point but doesn’t guarantee an AED is ready to shock or will be used. AED readiness, people readiness, and a widespread Culture of First Responders™ are the key principles to dramatically increase survival.


1 – AED Readiness

Ensuring that AEDs are ready to shock is a critical first step. An AED that malfunctions or has expired components is of little use during an emergency. Regular checks, maintenance, and timely replacement of parts (such as batteries and pads), and remote monitoring ensure AEDs are ready to shock.


2 – People Readiness

An AED is only as effective as the person operating it. More people need be trained to perform CPR and use an AED. However, even if individuals aren’t certified by an accredited training center, they should still be empowered to recognize the signs of Sudden Cardiac Arrest and be confident jump into action…“You, go call 911. You, go get an AED and First Aid Kit. I’ll start chest compressions.”


3 – Building a Culture of First Responders™

To close the AED to survival rate gap, we must also foster a widespread culture where all individuals (our family members, neighbors, friends, co-workers) consider themselves potential first responders, because this is the reality. The fear of doing harm, legal implications, or simply getting involved needs to be addressed. Everyone can be a hero in the quest to increase Sudden Cardiac Arrest survival.


It Doesn’t Have to be a Paradox

The AED Paradox serves as a compelling reminder that while technology is a powerful tool in the quest to save lives, it cannot operate in a vacuum. Increasing survival rates from Sudden Cardiac Arrest is not just about distributing more AEDs. It’s about ensuring that more AEDs are used effectively as part of a comprehensive life-saving strategy. With a coordinated approach encompassing the principles of AED Readiness, People Readiness, and a Culture of First Responders, we stand a better chance of moving the needle on Sudden Cardiac Arrest survival rates. It’s time to close the AED Paradox Gap!


*Disclaimer: Please note that in this post I have spoken generally to a general audience to make a point that survival rates are not increasing at the same rate as AED distribution. However, there have been outliers and success stories of increased survival in various arenas. Understanding these details can help us understand the actionable steps we can take to increase Sudden Cardiac Arrest survival. In my next post, I’ll outline how to dramatically step up the survival rate based on the principles in this post.

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