HEARTSAVER

FIR ST AID | CPR | AED

Your On-site AED Program

An Implementation Guide
 HEARTSAVER
®

FIR ST AID | CPR | AED

Your On-site AED Program

An Implementation Guide
Every year in the United States, more than 356 000 people have a cardiac arrest
outside of a hospital setting. Thousands of those people are at work when it happens
to them.

Unfortunately, less than half of those who have a cardiac arrest outside of a hospital
receive lifesaving help of any kind. And about 90% of them die.

When someone is in cardiac arrest, they need cardiopulmonary resuscitation (or CPR)
immediately. Many also need an electric shock (called defibrillation) to restart their
heart—and improve their chance of survival. Automated external defibrillators (AEDs)
provide those shocks. Studies show that early CPR and AED use—whether by a medical
professional or a bystander—can double or even triple a person’s chance of survival.

AED programs, like the one you are implementing, help reduce the time to
defibrillation by placing AEDs in businesses and in public places and by training
laypeople to use them.

Effective AED programs (sometimes called public access defibrillation or PAD

programs) aim to ensure that a person who is in cardiac arrest receives a shock within
3 to 5 minutes after they collapse. To make this possible, AEDs need to be placed
strategically throughout a workplace or a public space. This guide can help your
organization implement an effective AED program.

The American Heart Association applauds your decision to help save lives.

Note: This guide is provided for your convenience. The American Heart Association
does not recommend particular manufacturers’ products and cannot provide legal
advice. It does, however, publish research and offer training relating to heart health.

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Step 1: Check local requirements
Follow all of your state and local regulations for AED programs. Have
legal counsel review your AED program. If appropriate, your risk
management or safety team should also weigh in.

Liability
Laws can vary by state, county, or city. But they generally limit the liability of rescuers
using AEDs and of others involved in an AED program. The Cardiac Survival Act of 2000
encourages the placement of AEDs in federal buildings and ensures federal liability
protection for those who acquire or use an AED to save a life (read this report at
www.congress.gov/congressional-report/106th-congress/house-report/634/1).

Good Samaritan protection

Please read the Good Samaritan Act and any other relevant statutes for your state
and county.

State registration
You may have to apply to the state to create an AED program. Once it is set up, you may
need to register with your state or local emergency medical services (EMS) organization.

Medical oversight and collaboration

Your state may require that a physician review or oversee your AED program. If so, consult
with your state medical board or local EMS agency to identify an appropriate physician.

Step 2: Assess your organization’s needs

Quantity
The chances of surviving a cardiac arrest fall fast for every minute that defibrillation is
delayed. And the average EMS response time in the United States is 7 minutes.

So, to ensure that someone in cardiac arrest receives help ASAP, rescuers need to be
able to reach an AED within a 3- to 5-minute round-trip walk from anywhere at the
worksite. This means that it should take no more than 1½ to 2½ minutes to reach an
AED and 1½ to 2½ minutes to return to the emergency site.

Map out your site to decide how many AEDs you need to achieve this
spacing to the best of your ability. Be sure to account for obstacles
that could affect response time. Obstacles can include
• Crowded spaces where people might get in a rescuer’s way
(lobbies, cafeterias)
• Elevators, escalators, stairs
• Office furniture, cubicle walls, displays
• Locked doors

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Cost
Most AEDs cost from $1200 to nearly $3000 each. Buy enough AEDs so that one is
always no more than a 3- to 5-minute round-trip walk away. If that isn’t possible
right away, you can add more later, as your budget allows. Also budget for replacing
expired AED pads and batteries.

Depending on the AEDs you choose and where you will place them, you also may
need to buy dedicated cabinets or boxes.

To help employees become familiar with AEDs, consider also buying an AED trainer.
They give hands-on experience that boosts confidence for using a real AED in an
emergency.

Durability
All AEDs that the US Food and Drug Administration (FDA) approves must meet certain
standards. Each FDA-approved AED is given a 2-digit IP (ingress protection) rating. The
first digit (0-6) tells you how well the AED is protected from dust or other solids getting
inside. The second digit (0-9) indicates moisture protection. Higher digits mean greater
protection from dust and water.

How sturdy your AEDs need to be depends on

• Whether they might be used both indoors and outdoors (for example, in parking
lots or sports fields)
• Whether they will be carried in a vehicle (for example, to off-site work events)
• Whether they will be exposed to extreme weather conditions or temperature changes
Size and storage
AEDs come in various sizes and weights, but most are relatively compact. Where you
place them (for example, at a reception desk, on a shelf in a conference room, in a
dedicated cabinet that hangs on the wall) could affect how you install them, how
portable they are, and who will be able to use them.

Features
AEDs offer a range of features. Among the options to consider when weighing your
organization’s specific needs are
• Wi-Fi capability
• Child features (child pads vs a switch for giving a shock that is
appropriate for a child)
• Bilingual AEDs (English and Spanish)
• Real-time feedback on CPR quality
• Tracking software (to help you maintain your AEDs)

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Step 3: Research the AED market
Ask local EMS for suggestions. Then, compare models online to find the one that best
meets your needs. Also make sure that the AED has been approved by the FDA and is
simple and easy to use (see the list of FDA-approved devices here: www.fda.gov/medical-
devices/cardiovascular-devices/automated-external-defibrillators-aeds#approved).
Ask the manufacturer for either an on-site demonstration or a test model to try out.

Be sure that the manufacturer offers reliable, easy-to-access technical support.

Other things to check:

• Storage: Is there room in the AED cabinet for additional supplies (extra pads,
pocket masks, scissors)?
• How much maintenance is required
• The shelf life of the pads and batteries
• What support the manufacturer offers for registration, AED placement, training,
and supplies
• How quickly the manufacturer can send replacement components
A number of AED models on the market are suitable for company or public access use.
The American Heart Association does not recommend one device over another—only
that it be FDA approved.

Step 4: Buy the AEDs and other supplies

When you buy your AEDs, purchase extra pads. Each set of pads is good for 1 use only
and must then be replaced. Also buy enough extra pads to have 2 sets with each AED
(one set to remove chest hair, if needed, and one set to apply to the patient’s chest
and connect to the AED).

If your AEDs use disposable batteries, always have fresh backups on hand.

Additional items to include with your AED are pocket masks

and 1-way valves to protect rescuers; razors to shave hairy
chests; and scissors to cut off clothing, such as bras. It’s also a
good idea to have first aid kits available.

Step 5: Register your AEDs

Be sure to register your AEDs with the following:
• The state or local EMS, if required
• The manufacturer, to receive news of updates and recalls
Store registration information where more than 1 current staff member can find it. Also
store it in your organization’s safety emergency plan.

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Step 6: Place and post
Activate and install your AEDs
Important: Before you install your AEDs, remove each one from its box and insert the
batteries. Follow the manufacturer’s instructions to activate and test each unit.

Good indoor locations include

• Near elevators and in main hallways
• Near assembly lines
• In auditoriums, cafeterias, employee gyms, and reception areas
As you choose locations, keep in mind any obstacles from Step 2. And make sure your
AEDs are both visible and accessible. This means that
• Their placement meets Americans With Disabilities Act guidelines (you can find
these guidelines at www.ada.gov).
• They are not locked up in a cabinet, security office, or nurse’s office. Locking up
an AED might significantly delay its use in an emergency. It may reassure you to
know that AEDs are rarely stolen.
Post signs
Label every unit clearly as an AED (rather than only as
a defibrillator). The International Liaison Committee on
Resuscitation, a group made up of leading resuscitation
organizations around the world, suggests the following:
• Beside each device, post an “AED” sign that can be seen from at least 200 meters
away (approximately 655 feet).
– Use lettering that’s at least 12 centimeters high (approximately 5 inches) so that
it can be read from at least 50 meters away (approximately 165 feet).
• Also post signs that indicate the direction and distance to an AED.
• Illuminate AEDs at night.
• For AEDs that are outdoors, add supplemental lighting.
• Inspect AED signs at least once a year.
• Maintain your signs.
Provide necessary supplies
At all times, each AED storage box should have
• Two sets of unexpired adult pads (so rescuers can use one set to remove hair from
someone’s chest, if needed)
• Child pads (if your AEDs do not have a child shock feature, and depending on your
workplace needs; note: if children are rarely or never present, you may not need
child pads)
• Pocket masks and 1-way valves (to protect rescuers)
• Scissors (for cutting off clothing)

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If space allows, the following supplies are also helpful for providing CPR and using an AED:
• A razor (for shaving hairy chests)
• A first aid kit

Step 7: Manage your program

Recruit a team to set and manage AED policies and procedures. Make this a part of
your organization’s emergency response plan so that all staff are prepared for an
emergency. Assign specific liaisons to
• Set up training sessions
• Perform monthly AED checks
• Order new supplies
• Maintain all AED records (prescription, warranties, maintenance schedules)
• Check the FDA database for AED recalls (this database is available at
www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfRES/res.cfm)
• Work with local EMS, if needed

Step 8: Train employees

AEDs are simple enough for anyone to use. Most give prompts when you turn them
on. But specific AED training can enable people to recognize—and quickly respond
to—someone who is having a cardiac arrest emergency. And that, in turn, can improve
their chance of surviving.

Training is also important because

• People need to know how to use their company’s specific AED
• It builds confidence for taking action in a real emergency
The American Heart Association recommends that everyone learn what to do if they
encounter someone who is unresponsive. At the very least, your AED program training
should cover how—and whom—to call for help. But it’s best to provide full CPR and
AED training. The American Heart Association offers both classroom and eLearning
CPR and AED training.

Train enough people so that someone is always available to respond to a cardiac

arrest emergency. Remember: you can never have too many trained responders.

Learn more about training your workforce with Heartsaver® First Aid CPR AED by
visiting heart.org/workforcetraining.

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Build confidence
To help people feel confident enough to help save a life, AED
training should include
• Time for every person to examine the AEDs and to practice
• AED training video screenings for everyone (most
manufacturers have a video)
• Training for new staff
• Annual refresher training
Consider promoting your program every year during these 2 annual events: National
CPR and AED Awareness Week (June 1 through June 7) and World Restart a Heart Day
(October 16).

Step 9: Raise awareness

Publicize internally
Use company newsletters, posters, and social networking sites to let everyone know
where all the AEDs are and when the company will be offering training. Encourage
everyone to sign up for CPR and AED training.

Involve everyone
Encourage all employees to regularly glance at the AEDs. Does the status indicator
light show that the AED is ready for use? Does anything seem wrong? Things to report
may include damaged or missing units, a blinking red light, or a chirping sound.

Remind employees regularly

Periodically remind staff that AEDs are available. To make sure everyone knows where
the AEDs are located, add some fun. For example:
• Plan a search-and-find activity
• Invite everyone to post a selfie with one of the company’s AEDs

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Step 10: Maintain your AEDs
Maintaining your AEDs according to the manufacturer’s instructions is a critical part of
your AED purchase because only a working AED can help save a life.

So, appoint individuals or teams to

• Inspect every AED regularly
• Restock AED and first aid kit supplies
• Arrange for maintenance when needed
• Check with the manufacturer for software updates, upgrades, or recalls
Inspecting and maintaining the AEDs is a key responsibility. If your AED’s manufacturer
provides a checklist, use it. Otherwise, you should create your own checklist.

AED pad care is crucial

AED electrode pads have a water-based gel on them that helps

them stick to skin and conduct electricity. Over time, this gel can dry
out. If that happens, the pads will not work—and a life could be lost.

To be sure your AED pads are always ready and

working:
• Don’t open the pad packaging until you
need to use the AED in an emergency.
• Replace used pads immediately. Pads are
good for only 1 use.
• Check pad expiration dates regularly.
• Replace pads shortly before they expire.
• Be aware that pads exposed to extreme
temperatures or temperature changes
may degrade more rapidly.
Remember: Only a working AED can help save a life.

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Glossary

Term Definition

Automated external Automated means that the devices independently analyze

defibrillator (AED) a person’s cardiac rhythm. They are external because
the AED’s electrode pads are placed on the outside of
the patient’s chest. Defibrillator means that the AED
uses electricity to change an abnormal heart rhythm
(fibrillation) back to a normal rhythm.

Cardiac arrest The heart malfunctions and stops beating. Without help
(CPR and, if needed, defibrillation), a person in cardiac
arrest will die within minutes.

Cardiopulmonary A lifesaving emergency procedure for someone who

resuscitation (CPR) has signs of cardiac arrest (ie, unresponsive, no normal
breathing, and no pulse). The 2 key components of CPR are
chest compressions and breaths.

Defibrillation A process in which an electronic device (either a defibrillator

in the hospital or an AED outside of the hospital) gives an
electric shock to the heart

Electrode pads Pads that are placed on the bare chest of someone who is
in cardiac arrest and then attached to an AED. The pads are
coated with a water-based gel that helps them stick to the
skin and conduct electricity.

Public access When members of the community use AEDs that have been
defibrillation (PAD) placed in high-traffic public places—such as casinos, gyms,
sports complexes, airports, and shopping malls—to provide
defibrillation for someone who is in cardiac arrest

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 Learn more about AEDs at
cpr.heart.org/en/training-programs/aed-implementation.
For more information about American Heart Association
lifesaving courses and programs, visit cpr.heart.org.
Learn more about training your workforce at heart.org/workforcetraining.

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