Buying a defibrillator - what do I have to consider?

1. Pediatric mode

This is nothing new: Just as, for example, the drug dose for children is usually lower than that for adults, so it is with the energy required for defibrillation: It must be lower for children than for adults. In order for an AED to be usable on both groups of people in an emergency and to provide them with adequate care, there are two options:

• The device has a paediatric mode with reduced energy levels which is automatically activated when paediatric electrodes are used
• The device is additionally equipped with a special paediatric button which (using the adult electrodes) allows activation of a dedicated paediatric mode

2. Multiple languages

Airports, stadiums, public facilities: We don't know who will be on the scene to provide first aid - and what language he or she speaks or understands. To ensure that first aid can be provided as quickly and effectively as possible at any time, it must be ensured that the first-aider can operate the AED in a language which he or she understands. The defibrillator should therefore be able to provide its instructions in as many different languages as possible.

3. Follow-up costs

What are the initial and subsequent costs of a defibrillator? Of course, in addition to safety, the price is also a decisive factor in our purchase decision. But people often make one big mistake: When buying, they only look at the purchase price and overlook the subsequent costs. Also in the area of defibrillators it can happen that a supposedly cheap product is bought – but the consumables are much more expensive and maybe even less durable. Therefore, do not think too short-term when purchasing, but calculate the costs for a product lifetime of 10 to 12 years. You can find an example calculation here.

4. Self-tests

How often does a defibrillator need to be serviced and can it actually test itself? Yes, an AED should perform self-tests periodically and document them in the device. This ensures that it is safe and reliably available at all times – for immediate readiness for use in an emergency. The more frequent and comprehensive these self-tests are, the more meaningful they are.

5. IP protection class

In the public swimming pool, on the construction site or at large events: Depending on where you store and use your AED, you may also need to consider environmental conditions. When used outdoors, moisture and dust may cause problems, for example. For this reason, most devices are protected accordingly – and the so-called “IP protection class” indicates how well they are protected against moisture and dust, for example. The general rule for the protection class is: The higher the first digit (protection against foreign bodies) and the second digit (protection against moisture), the better the overall protection. Two examples:

• Protection class “IP 21” simply means: “Protected against solid foreign bodies with a diameter ≥ 12.5 mm and protection against dripping water”
• The protection class “IP 55” means: “Protected against dust in harmful quantities as well as against jets of water (nozzle) from any angle” – and therefore offers considerably better protection than class “IP 21”

6. Status display

A defibrillator must always be ready for use – how can this be checked? Typically, an AED has a status indicator that shows whether the device is ready for use. This status display should consider the following aspects: 

• Differentiated display performance: If this is not the case, only the ready or not ready condition of the device is displayed, for instance. In the event of a fault, this often makes it impossible for the operator to rectify the fault, as the cause is not known
• No dependence on battery capacity: If it were to be dependent on the battery, the status display may show nothing when the battery is empty. The worst case scenario is obvious: The AED cannot indicate the exhausted battery capacity or alert the operator – and would not be ready for use in an emergency

7. Amount of energy

How much energy is required for defibrillation? As a rule, the first shock is given with a moderate amount of energy. If this is not successful, the energy levels of the subsequent shocks should be increased. The German Resuscitation Council (ERC) has issued guidelines for this: These dictate that, for biphasic pulse shapes, the first shock should be delivered with an energy of at least 150 joules, the second and subsequent shocks with 150-360 joules.

In short: An AED should be able to deliver biphasic energies of up to 360 joules in order to provide sufficient power reserves for follow-up defibrillations with higher energies – as is the case, for example, with all devices in the PRIMEDIC HeartSave series.