Recessed Enclosure

The AED (Automated External Defibrillator) revolution that holds much promise against the loss of more than 325,000 American lives annually suffers from two severe limitations – a cruel time limit and ad-hoc deployment.

Each minute that goes by following a sudden cardiac arrest lowers any chance of survival by 10%. Resuscitation drops from 70% with timely AED intervention to just 5% with manual CPR alone.

The technology itself is marvelous – AED’s are compact, designed for use by untrained people, and highly effective when utilized within the first few minutes. But the severe premium on elapsed time before delivering this life-saving shock precludes our simply calling 911 or awaiting an ambulance. The victim is not breathing and clearly cannot wait at all.

There are two parameters left to be optimized, however, that can greatly improve the effectiveness of AEDs – proximity and delivery.

Proximity

AEDs are becoming common at athletic and transportation facilities, because the likelihood of someone needing one rises with exertion, and from crowd densities. This strategy is first-generation, and now attention must be paid to where these people live and work, which increasingly is within high rise buildings and complexes. In large cities such as New York and Chicago, traffic and high-rise elevators are serious impediments to the EMS system ( See http://elevaed.com/?p=88 ).

Accordingly, placing AEDs inside office towers or residential high rises raises the ratio of people-per-AED who become protected. This not only lowers the AED’s cost per individual, it also greatly shortens its average distance from them in an emergency.

Optimizing Proximity – Elevator Lobbies

To overcome the difficulty EMS/911 crews have accessing high-rise buildings, the only approach is to have the device already on-site, and the next imperative is that the AED should be placed in the main lobby beside the elevators.

Why? Elevator lobbies are best for the following reasons:

1. Just one AED adjacent the elevators can serve an entire building with many suites or offices, making its singular cost almost negligible.
2. Security is much stronger in lobbies, and the device can remain unlocked and ready, especially if it is monitored.
3. The residents, workers and employees become aware of its location and procedures, which eliminates confusion in an emergency.
4. The building’s ‘vertical community’ will come to associate AEDs with elevators, and take a proprietary interest in their ‘friends in high places’.

Clearly an AED in each elevator lobby shall become mandatory via  building codes or government statutes. In the meantime, let’s save some lives.

Optimizing Delivery – Elevators Themselves

While proximity is critical, the time frame of mere minutes demands almost immediate delivery of the AED and its use. Again – the victim otherwise has a survival rate of 5% and has effectively died.

An AED in a downstairs lobby or common room will, at minimum, involve  descending by elevator to the proper floor and returning to the victim’s office or residence. Even if this race goes uninterrupted it absorbs time, interruptions can occur, and some of the AED’s benefit will be lost.

The visionary approach is to have an ElevAED onboard each passenger elevator, so that the device is on its way the moment the elevator is called. This dynamic distribution of AEDs is ideal for sharing these miraculous devices in tall buildings. The precious minutes saved will mean life or death, or a return to normalcy vs a permanent brain injury for SCA victims.

Schiller Easyport AED

The form factor of AEDs has been reduced such that a small 6″x6″x2″  compartment in an elevator control panel can house a fully functional AED. So the fundamental question is this: Do we have the maturity as a society to incorporate AEDs into elevators successfully?  Shall we be frustrated by political foot-dragging, indifference and potential thieves, or shall AEDs come to be as accepted and recognized as fire extinguishers?

There is an opportunity here, using astute AED deployment to transform tower buildings from being the most hazardous during an SCA, to becoming the safest place to be outside of hospitals. Clearly the first step is to target the high-rises and continue until AEDs and elevators are integrated .