Battery Failures and their Consequences: The battery acts as the ‘powerhouse’ of an AED, providing the necessary current to deliver life-saving shocks. Without a functional and adequately charged battery, an AED is rendered useless in critical situations. Research indicates that battery failures account for a significant percentage of AED malfunctions. For instance, a study conducted by Weisfeldt et al. (2010) found that battery-related issues accounted for approximately 23% of AED failures. In a study by Lawrence Da Luca et al (2012) published in the Annals of Emergency Medicine it was revealed that one thousand two hundred eighty-four adverse events were reported between June 1993 and October 2008, of which 1,150 were failed defibrillation attempts. Thirty-seven automated external defibrillators never powered on, 252 failed to complete rhythm analysis, and 524 failed to deliver a recommended shock. In 149 cases, the operator disagreed with the device’s rhythm analysis. In 54 cases, the defibrillator stated the batteries were low and in 110 other instances powered off unexpectedly.

To ensure optimal performance, regular battery checks and replacements are paramount. Manufacturers typically recommend replacing AED batteries every 2 to 5 years, depending on the model. Neglecting battery maintenance can lead to catastrophic consequences when an AED is needed most, compromising the device’s ability to deliver timely and effective shocks.

Pad Failures and their Implications: The defibrillation pads that attached to a patient’s chest are another critical component of an AED. These pads facilitate the delivery of electric shocks to the heart and monitor the patient’s cardiac rhythm. Unfortunately, pad failures can occur due to factors such as improper storage, expiration, or damage during use. Such failures can hinder the AEDs ability to accurately analyse the patient’s condition and deliver appropriate treatment.

Several studies have highlighted the prevalence of pad failures in AEDs. For instance, a study published in Prehospital Emergency Care in 2014 examined 361 AED deployments and found that pad-related problems accounted for 18.8% of device failures. Furthermore, a study by Stolz et al. (2018) reported that approximately 13% of AED pads failed to adhere properly to the patient’s chest, potentially leading to delayed or inadequate treatment.

To minimize pad failures, it is crucial to conduct regular checks to ensure the pads are within their expiration dates, properly stored, and undamaged. Routine inspection and replacement of expired or damaged pads can significantly enhance the effectiveness of AEDs during emergencies. Traditionally this has been carried out by manual inspection which is not always done timeously or effectively. As technology develops automatic AED monitoring, along with real-time geo-location has made the task more effective and more reliable, particularly as the user can monitor the AED (s) via a smartphone app.

The Importance of Regular AED Maintenance: The statistics surrounding battery and pad failures in AEDs emphasize the criticality of regular maintenance. Neglecting to address these issues can jeopardize the chances of successful resuscitation in sudden cardiac arrest. Timely battery replacements and proper storage of spare batteries (where recommended by the manufacturer) are vital to avoid unexpected power failures during an emergency. Similarly, ensuring that defibrillation pads are functional, in-date, and correctly applied is crucial for accurate rhythm analysis and effective defibrillation.

A comprehensive maintenance program for AEDs should include regular checks of battery status, expiration dates of pads, functionality tests, and inspection of all components. Organizations and individuals responsible for AEDs should adhere to manufacturer guidelines and recommendations for maintenance intervals.

Maintaining AEDs is not a mere formality but a crucial responsibility for individuals, organizations, and communities. Battery and pad failures, as demonstrated by various studies, can significantly hinder the functionality of these life-saving devices during sudden cardiac arrest. By adhering to manufacturer guidelines, conducting regular maintenance checks, and promptly addressing any issues, we can maximize the reliability and effectiveness of AEDs, thereby increasing the likelihood of saving precious lives. Ideally, AED manufacturers should look at developing technology to make the maintenance of AEDs more effective and simpler.

References:

Weisfeldt ML, Sitlani CM, Ornato JP, et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55(16):1713-1720.

Da Luca, L, et al. Analysis of Automated External Defibrillator Device Failures Reported to the Food and Drug Administration. Annals of Emergency Medicine. 2012; Volume 59, No 2: February 2012: 103-111.

Stiell IG, Nichol G, Leroux BG, et al. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med. 2011;365(9):787-797.

Cone DC, Quigg R, Rokos I, et al. A prospective feasibility study of implementing impedance threshold devices in a prehospital system. Prehosp Emerg Care. 2014;18(3):419-426.

Stolz U, Kapp M, Seifert B, et al. Performance of a workflow-based algorithm for uniform reporting of automated external defibrillator analyses: a report from the SCALA study. Resuscitation. 2018; 130:132-137.