An Automated External Defibrillator (AED) is a portable medical device designed to treat sudden cardiac arrest (SCA), a condition where the heart unexpectedly stops beating effectively. SCA is often caused by an electrical malfunction, leading to a disorganized rhythm called ventricular fibrillation. The AED analyzes the heart’s rhythm and delivers an electrical shock to restore a normal heartbeat. Because the chance of survival decreases by up to 10% for every minute defibrillation is delayed, the physical placement of an AED within a structure is essential. This guide provides direction on where and how to install these devices for optimal emergency response.
Determining the Necessary Coverage and Quantity
The initial phase of AED implementation involves calculating the total number of devices required for adequate coverage. The primary consideration is the “3-minute rule,” which suggests an AED should be retrieved and the first shock delivered within three to five minutes of collapse. Meeting this target often requires the rescuer to reach the AED and return to the victim within 90 seconds one-way.
Building managers must perform a walking-time test to ensure this response window is met from all points within the structure. This testing should account for obstacles like stairs, elevators, locked access points, and crowded areas, as these significantly increase transit time. For example, a large, multi-story office building often requires at least one AED per floor to maintain the rapid response standard.
The total square footage, the number of occupants, and the average level of physical exertion on the premises also influence the final quantity. Facilities with high population density, such as schools or shopping centers, may require more AEDs than a low-occupancy warehouse of the same size. A simple calculation involves dividing the total square footage by a maximum coverage area, typically 75,000 to 100,000 square feet per AED, but this must be adjusted based on the specific layout and the 3-minute response goal.
Strategic Placement Based on Building Use
Once the necessary quantity is determined, devices should be strategically placed in areas with a higher probability of sudden cardiac arrest or high foot traffic. Locations where physical exertion is common pose an elevated risk, making areas like fitness centers, on-site gyms, and loading docks high-priority placement zones. Even in a typical office building, areas like the cafeteria or break rooms, where large groups of people congregate, are ideal central locations.
For large structures, placement should focus on high-traffic corridors, main lobbies, and centralized vertical access points like elevators and stairwells. In manufacturing facilities, AEDs should be near assembly lines or areas where electric-powered devices are used, due to the risk of electrocution or high-stress work. Schools should place units in gymnasiums, athletic fields, and administrative offices, while conference centers should have devices near main entrances and exits.
In buildings with multiple distinct sections or separate campuses, each area or building should be treated as its own zone for placement consideration. Strategic placement ensures the AED is located where it is most likely to be needed, maximizing the speed of access.
Ensuring Immediate Visibility and Access
The final step involves ensuring the installed AED is visible and accessible during an emergency. The device must be housed in a clearly marked, unobstructed location, often in a wall-mounted cabinet. The cabinet should not be locked, as any barrier to immediate access can negate the device’s effectiveness.
To comply with accessibility guidelines, the handle of the AED cabinet should be mounted no higher than 48 inches from the floor. Standardized, highly visible signage is important, using the universal heart and lightning bolt icon to clearly indicate the location. Projecting or V-shaped signs that stick out from the wall are particularly effective in long corridors, as they are visible from multiple directions.
Clear pathways to the device must be maintained, and the area should be well-lit to prevent confusion or delay. While federal law does not mandate signage, state and local regulations often require specific labeling. Building occupants and local emergency services, such as the 911 dispatcher, must also be informed of the AED’s precise location to coordinate the fastest possible response.