We should buy the same AED that the local EMS department uses so that it is “compatible”

Not necessarily. Defibrillators used regularly by professionals are designed differently than those intended for infrequent use by laypeople. Select an AED based on the needs of the people who will use it. Most professional EMS services will remove AED pads applied by laypeople when they arrive, so there is little need to use the same brand that they do. If your organization does require your AED pads to plug into your EMS service defibrillator, then you may wish to consider an inexpensive pads adapter plug that allows Philips HeartStart pads connectors to plug into many popular advanced EMS defibrillators.

Some “fully automatic” AEDs don’t even require the user to push a shock button. These are better and easier.

Several manufacturers have introduced fully automated defibrillators that do not require the user to push a shock button. Once connected to a patient, they will automatically shock as required without any further intervention.

These “auto-shock” AEDs may seem like a great idea, but this “feature” has several key flaws in reality:

• They are dangerous – the requirement that a user press a shock button is a valuable safeguard against accidentally shocking a bystander. Not surprisingly, incidents of injuring bystanders are starting to be documented with these devices.
• They take a very long time to shock. In an effort to compensate for the danger inherent with delivering automatic shocks, they generally delay the shock to allow adequate time to warn users to stand clear. This delay in therapy reduces the chance of patient survival.
• They are unnecessary. Studies have well documented the functional areas of AED use that lay people commonly have problems with. Simply pressing the “shock” button when instructed is not a common problem.

Philips HeartStart Defibrillators deliberately do not offer an “auto-shock” feature.

We should get an AED that has escalating or high energy in “reserve” because some heavy patients need extra energy.

The advent of modern impedance-adjusted biphasic defibrillation waveforms now allows successful defibrillation of patients at much lower energy levels than was previously required with monophasic defibrillators, and does less collateral damage to the heart muscle. Although all biphasic AEDs are generally good at defibrillating (stopping ventricular fibrillation), lower energy waveforms are better at getting the heart to start beating in an organized rhythm after the defibrillation shock is delivered, and result in a better overall chance of survival.

Although it is tempting to think that “more is better” high energy biphasic defibrillation has not been shown to be more effective at defibrillation (even in very large patients). High energy defibrillation shocks have been shown to be detrimental, as they tend to “stun” the heart after defibrillation, and reduce the chance that a perfusing heart rhythm will result. The suggestion that high-energy defibrillation is desirable is generally perpetuated by manufacturers that sell AEDs using older technology defibrillation waveforms that rely on high-energy defibrillation.

All AEDs are FDA approved and are basically the same.

An AED is a complex device —buy quality. Consider the reputation of the manufacturer—many have been plagued by device recalls and regulatory actions. “Bargain” AEDs may seem like a great deal initially, but may be of dubious quality and costly in the long-run.

I saw a study from XYZ Defibrillator Manufacturer that said they make the best AED…

Not surprisingly, almost all AED manufacturers are eager to offer up scientific data from “studies” to substantiate claims that their product is somehow the best available. We continually review claims and studies from many manufacturers and 3^rd parties. Many manufacturer claims do not stand up to scrutiny. We encourage you to be skeptical and consider the following points:

• Is the benefit or claim actually substantiated by the study data or is it being taken out of context?
• Is the study based on animals or human subjects, in real world emergencies or laboratory conditions?
• Is the study based on a large number of subjects or just a few?
• Is the study peer-reviewed, and published in a major scientific journal? (Usually all of the points above will determine this.)
• Is the conclusion drawn consistent with the results of other major accepted peer-reviewed literature on the subject, or are these wildly different claims?