The Importance of Annual Inspections on AEDs and Defibrillators

Edge Biomedical shares tips on why it's important to have inspections on AED and manual defibrillators, how often to inspect machines, necessary steps and more. Have a question for the expert or want to find out more after reading his tips? Fill out the form at the bottom of the page to ask Matt Spencer a question directly.

How often should AEDs and manual defibrillators be inspected and why?

AEDs (Automated External Defibrillators) and manual defibrillators have several different inspection schedules, but to make things even more confusing, there are different levels of “inspections.” For the purpose of this article, we will focus on what needs to be done at a bare minimum to ensure the device will be ready to use in an emergency.

While sudden cardiac arrest is the biggest cause of death in the country, it is still rare enough outside the hospital that the likelihood of an AED you place in a school, office or public space being used may be slim. The fact that your AED may be used seldom, or never, creates an even bigger need for proper maintenance and inspections. Have you ever grabbed a flashlight in the middle of a blackout, only to find that the batteries are dead? If blackouts were frequent, I bet you’d keep that flashlight in good, working order. A pilot once told me that the purpose of having a flashlight in his flight bag was to carry dead batteries. Pilots have a strange sense of humor, but the joke demonstrates the result of ignoring regular maintenance for important devices, and the negative repercussions that neglect can have when you need that device most.

What are some important differences between AEDs and manual defibrillators that health care facilities and biomed departments should be aware of regarding service and maintenance?

AED manufacturers understand the possibility of infrequent use of their devices and the likely absence of the personnel whose sole responsibility it is to maintain the AED (there are no people with the title “AED Inspection Manager”). Because of this, AEDs have regularly scheduled “self-checks” that run a system of tests to determine if the AED is ready to perform on a victim. If the AED does not pass these tests, the device will beep incessantly until the failed test is addressed. This is very similar to smoke detectors when they detect a low battery (the manufacturers ensure that the smoke alarm ONLY detects a low battery between the hours of 1 and 3 am.) The solution to the incessant beeping is NOT to take the battery out. You must order a new one immediately. Most devices begin to alert you that the battery is low when there is less than 20% of capacity remaining. 

These self-checks are set by the manufacturer, but some AEDs allow the frequency to be changed. For example, Cardiac Science G3 and G5 AEDs conduct daily self-checks on themselves, while other manufacturers, like Philips and Zoll Medical, test weekly. There are benefits to both; daily self-checks will discover a problem quickly, whereas weekly self-checks conserve the battery life. 

Manual defibrillators from Physio-Control, Zoll Medical and Philips require daily testing because these devices are used by healthcare professionals, such as, nurses, doctors, EMTs. Each daily test is a bit different, so be sure to refer to the user guide for the proper, required maintenance. 

Can you share a brief outline of the steps needed to properly maintain AEDs and manual defibrillators?

AEDs will self-test themselves, but many state programs require a visual inspection to be performed on the AED every 30 days. When visually inspecting an AED, it is important to note that there is no visible damage to the AED and the readiness indicator shows the appropriate signal. These signals vary from manufacturer to manufacturer, but most are a version of green/red. With Zoll, it is a green check mark or red X. With Cardiac Science, it is a green circle or red circle. Always familiarize yourself with these indicators by referring to the user guide of your particular AED or contact the organization that sold you the device. During this visual inspection, you must also make sure the defibrillation electrodes are not past their expiration date. 

Manual defibrillators (LIFEPAK series from Physio-Control, Zoll Medical’s M Series, E Series and X Series, and Phillips XL and MRx) have a much more comprehensive test procedure that must be conducted by trained biomedical technicians. Each parameter of the defibrillator must be checked according to the manufacturer guidelines found in the service manual and pass a long list of calibration tests to ensure they are performing within the range stated by the manufacturer. If the desired range is not achieved, further steps are taken by the technician to correct the problem. Manual defibrillators are used much more frequently by first responders, therefore are subjected to greater physical abuse (heat, cold, moisture, dropping, jostling, etc.). While these life-saving devices are built to withstand greater physical trials, they are still a “machine,” and machines require maintenance to avoid failures.

A word of caution regarding defibrillator safety: these devices provide a great deal of energy through a “shock” that can reset a struggling heart. That same “shock” can also stop a heart that is performing normally. This aspect is what makes servicing them more dangerous than most medical equipment.

How can Edge Biomed benefit health care facilities in regard to AED and manual defibrillator inspections?

Edge Biomedical takes a special interest in defibrillators (both automated and manual) because they require that respect. Our annual inspections of these devices are completed 100% according to the manufacturer’s guidelines and documented in our proprietary asset management software, eBioTrack. We also provide our customers with recommendations by the manufacturers; not just requirements. A good example is recommended battery replacement frequency. We have seen batteries perform at a satisfactory level for ten years, but the manufacturer recommends replacement every 2 years. We will share that information with the customer to allow them to make an informed decision.

What else is important regarding the annual inspection of AEDs and manual defibrillators?

Manual defibrillators often have many different features, like pacing, 12-lead ECG, pulse oximetry, non-invasive blood pressure, invasive blood pressure, temperature, carbon dioxide/carbon monoxide monitoring and an AED mode. All these features have dedicated boards and parts that can, and do, fail. Testing them according the manufacturer’s specific guidelines is essential for many reasons. Patient and user safety are the biggest reasons, but legal protection and extended life cycle is important as well. 

AEDs are not to be purchased and forgotten. They must be maintained by their owners. The most common cause of failure in AEDs is a dead battery. There are several lawsuits stemming from AEDs not being ready for use when they are called upon. My pilot friend would counsel against buying an AED just to hold a dead battery.

For additional information, visit Edge Biomedical.