What does an automated external defibrillator cost

Automated external defibrillator

Synonyms: AED, automatic external defibrillator, defibrillator, early defibrillator, lay defibrillator
English: automated external defibrillator

1 definition

A automated external defibrillator, short AED, is a medical device that independently analyzes the heart rhythm and can deliver a current pulse if necessary. The automated external defibrillator was specially designed for use by laypeople and supports laypeople reanimation through acoustic and optical signals as well as spoken instructions.

2 devices

The AED are handy devices that are designed to be as easy to use as possible. Many defibrillators now only have a power button (fully automatic machines, see below). Furthermore, the electrodes in the form of adhesive electrodes (also: pad's patches, fast patches) are available with every AED, a pre-connection (electrodes in the packaging, cable protrudes from the packaging and is already connected to the AED) is now standard. The adhesive positions of the electrodes are usually shown on the packaging of the adhesive electrodes and on the adhesive electrodes themselves. In addition, some AEDs come with a package of tools, e.g. B. razors, respirators or gloves. A number of manufacturers are now represented on the European market with their own AED.

3 modes

AEDs can be operated in fully automatic and semi-automatic mode. Fully automatic means that the defibrillator is triggered when a shockable rhythm is detected (ventricular fibrillation, ventricular tachycardia> 180 / min1) independently triggers a shock. For this purpose, the user is asked several times by voice instruction not to touch the patient any more, and then (often after a countdown or further acoustic warning signals) the shock is carried out without any action on the part of the user. In the semi-automatic mode, the AED also warns not to touch the patient anymore, but then informs that the shock has been released and that a button (usually flashing) should be pressed to deliver the shock. The supporters of the semi-automatic machines point out that the pre-shock phase required by the ERC in the guidelines2, i.e. the time from the analysis to the triggering of the shock can only be kept as minimal as the warning time alone massively exceeds the 5 seconds required by the ERC. Supporters of the fully automatic machines, on the other hand, often argue that the subjective feeling of security of the lay user is supported if he does not have to make the decision himself.

4 Use in children

Most AEDs are only suitable for use by children aged eight and over. If the area of ​​the upper body is not sufficient for normal electrode positioning, these can also be centered on the thorax in a.-p. Position to be glued. Some devices have special children’s electrodes or a so-called “child’s key” which automatically reduces the energy output when they are used.

5 Legal framework

AEDs are active medical devices and in Germany are subject to the Medical Devices Act and the Medical Device Operator Ordinance. Regular checks, user training, keeping a medical device book and professional medical supervision are prescribed for the corresponding products. Most devices on the market are STK-exempt, i.e. internal daily, weekly and monthly functional analyzes mean that the AED does not have to be checked for function on a daily basis or regularly checked by medical technicians. The AED usually shows on a display when the function is disturbed or e.g. the battery is empty. The regular inspection required by the MPG is limited to an external visual inspection of the housing for defects and observing the display for error messages.

Most derive the possibility of use by laypeople from the fact that saving a human life is fundamentally more important from a legal point of view than the MPG (Section 34 of the Criminal Code). Furthermore, Section 1 (2) of the MPG is often cited: "This regulation does not apply to medical devices that are neither used for commercial nor economic purposes and where no workers are employed in the danger zone." This problem is also addressed in the comments on the aforementioned law.

6 signs

As a reference to an AED, there is also an international symbol for AED corresponding to the international symbol for first aid (white cross on a green background). In addition, locally known symbols are often attached to indicate an AED location. For the use of AED by lay helpers, there is also a background board that provides laypeople with brief and simple information about the steps that are now required.

7 Procedure

The activated AED always assumes that resuscitation is in progress. In order to keep the compression-free time as short as possible, most AEDs begin with a voice prompt after activation to continue the resuscitation. This is followed by the prompt to place the electrodes on the chest. If someone has already attached the electrodes before activating the device, this will be recognized by the device immediately and the points mentioned will be skipped. As soon as the device senses resistance between the electrodes (patient), it prompts not to touch the patient and starts an analysis. Then, depending on the rhythm, a shock is released or not or triggered (see modes). After the shock has been triggered or the information that a shock is not required, the device prompts you to continue the resuscitation. This analysis cycle is repeated every two minutes in accordance with ERC guidelines. Some AEDs support resuscitation between analyzes by means of a metronome, a clock that either only specifies the rhythm of the chest compressions or even the alternation between compression and ventilation.

The device cannot detect that the patient is awakening; it is assumed that the awake patient defends himself against chest compressions carried out on him.

8 Public Access Defibrillation

PAD concepts are becoming more and more popular all over the world. Several studies from the United States have shown that PAD concepts together with the training of semi-professional helpers (security, police, ...) are particularly successful in highly frequented places. But projects based entirely on lay resuscitation (e.g. the AED project in the Munich subway, AWI Krefeld, defiköln) are also useful and have achieved success. However, in the area of ​​PAD in particular, continuous and low-threshold information and training for the population is indispensable. In the USA and e.g. in Japan, PAD projects have become commonplace.

9 literature

  • ERC Guidelines 2010
  • Martin Gruner: Early Defibrillation. Stumpf + Kossendey Verlag, Edewecht 2006
  • ERC guidelines on basic life saving measures for adults and AED use
  • MPG, MPBetrV (www.Gesetze-im-Internet.de)

10 links

  • www.defiköln.de
  • www.awi-krefeld.de
  • www.defi-du.de
  • www.defi-neuss.de