Automatic External Defibrillator (AED): Gotta Have It!

With the aging of the population, a dentist's chance of encountering sudden cardiac arrest (SCA) during a patient visit, while thankfully rare, is an increasingly likely possibility. CPR has traditionally been the first response to cardiac arrest, but often defibrillation is required. Although full-function defibrillators require training and certification, the wide availability of automatic external defibrillators (AED) have made this life-saving technology readily accessible.

Weighing 3.3 pounds, this small and lightweight defibrillator uses clear, natural voice instructions. It guides the user through each step of defibrillation, pacing and adapting voice instructions to the user's actions. Additionally, on-demand CPR Coaching helps the stressed user recall their training. One of the most popular AEC is the Philips HeartStart OnSite.

Most states require defibrillators for dental practices that use general anesthesia or deep (unconscious) sedation, and many require them even if the practice uses conscious sedation. Several states require AEDs or full function defibrillators for all dental practices. The ADA Council on Scientific Affairs, in March 2002, recommended that dentists consider purchasing an AED for dental offices in which emergency medical services personnel with defibrillation skills and equipment are not available within a reasonable time frame. Thus the question seems to be, why wouldn’t your practice purchase an AED?

Most debate seems to be centered around the false sense of security an AED might generate. Although easy for a lay person to use, AEDs are much more effective in the hands of trained personnel. Some critics fear that untrained individuals will waste time improperly employing an AED instead of calling 911. If AEDs are not placed where they can be easily accessed, more time might be wasted searching for the device before calling for help. If the AED is not properly maintained and will not function, again it may distract personnel from getting help expeditiously. Although these are serious concerns, the HeartStart OnSite is designed to address just these issues—it automatically prompts the user to call 911.

When you do acquire an AED, a few tips:

• Don't rely only on instructional material provided with the AED. Enroll yourself and your personnel in a course to learn how to use your automated external defibrillator properly. This will also allow you to come to the rescue if someone experiences cardiac arrest in a public place and there's an AED nearby.
• Take the automated external defibrillator to a doctor's office and demonstrate how you and your personnel would use it, to make sure you're using it correctly.
• Have a practice run in your office using the automated external defibrillator as you would in an actual emergency. Remember, the AED works only on certain types of cardiac arrest. Know what steps to take if the AED indicates a shock isn't needed but the person remains unresponsive.
• Review your automated external defibrillator instructional material every three to six months to make sure you remember how to use the AED.
• Store your automated external defibrillator in an easily accessible place and make sure all personnel know where it is.
• Keep the automated external defibrillator maintained properly, including installation of new batteries as needed.