How can the "life-saving tool" in public places be "found and used"?

Recently, in Weihai, Shandong, a private car owner had their car window smashed, and a self-purchased AED (automated external defibrillator) inside the vehicle was taken by a passerby to save a patient who had suffered cardiac arrest. The owner not only did not pursue responsibility, but instead felt comforted that the AED truly ended up being put to use.

This heartwarming rescue has also sparked widespread public attention and reflection on AEDs: When danger occurs, do we find and use an AED correctly right away? Are AEDs in public places configured reasonably?

Recently, reporters from the Workers’ Daily visited multiple public venues in Beijing and found that although AED deployment in some places has been steadily improving, there are still certain high-traffic venues with a higher risk of cardiac arrest where there are issues such as missing equipment, unreasonable configuration, and staff being unfamiliar with how to operate it.

AED deployment in public places is being improved

“When I went for a run at the Olympic Forest Park not long ago, I noticed that a new AED had been added beside the track.” Mr. Liu, a Beijing resident, shared his observations on a social platform.

The reporter called the park’s staff and learned that, currently, besides AEDs clearly marked on the map, AEDs are installed at various locations across the park—at each gate, visitor service centers, security offices, and so on—allowing basically full coverage of the park. “Running is a high-incidence scenario for cardiac arrest, and with the park doing all this, we feel more at ease,” Mr. Liu said.

At the Longtan Lake Sports Arena, the reporter saw an AED placed behind the service counters on each floor. “The venue invites professionals to train every year to ensure we can operate it skillfully and handle emergencies.” A staff member of the arena said.

AED coverage at subway stations is relatively well developed. At Beijing Subway Wangfujing Station, the reporter observed that inside the AED box in the station hall, a card indicated the time of each equipment check. “AEDs are installed in prominent locations at every station, and designated personnel regularly check the quality of the equipment.” Station staff told the reporter. The staff also掌握掌握 cardiopulmonary resuscitation skills, and undergo annual skill re-checks.

“Outside-hospital cardiac arrest, 80%～90% of the initial rhythms are ventricular fibrillation or pulseless ventricular tachycardia, and the AED is the only method that can terminate ventricular fibrillation and restore a sinus rhythm.” Yuan Lin, deputy director of the emergency and critical care center and chief physician at Beijing Anzhen Hospital, said. “Standardized AED deployment in public places can significantly increase the success rate of emergency care, and is an important measure to safeguard public life and safety.”

Some public places lack AEDs

At 5 p.m. in a park in Beijing, many runners moved through the dedicated running lanes. Along the track, when the reporter asked nearby staff whether there were AEDs in the park, a staff member said, “We usually handle accidents like tourists twisting their ankles or bumping into things. In the security office, there’s only a basic first-aid kit.”

As one of the most densely trafficked areas, core commercial districts also face issues with missing equipment. At a certain commercial street, the reporter asked service desks at several shopping malls one after another and found that most malls do not have AEDs.

“Although there are currently no clear legal requirements for commercial venues to be required to equip AEDs, in emergencies, when AEDs in public places are used to save lives, legally it is usually considered an act of emergency avoidance, and in principle there is no need to承担赔偿责任.” Zhang Qihua, a partner at Beijing Lun Law Firm, explained.

Even if AEDs are equipped, the dilemma of “not being useful when it matters” still exists.

Mr. Liu, a sanitation worker at a park, told the reporter that there is an AED in the park’s security office, and two or three years ago they also organized related training, but since it had been so long, he basically forgot how to operate it.

“Once cardiac arrest occurs, defibrillation every minute reduces survival rates by about 7%～10%. This is what we commonly call the ‘golden 4 minutes’—defibrillation within the 4 minutes after cardiac arrest greatly increases the chances of successful emergency treatment.” Yuan Lin said.

However, in some venues, the layout of AEDs is not reasonable, making it difficult for the equipment to be brought to the scene within 4 minutes. “The mall has only one AED, located at the service desk on the underground level 2.” A staff member at the mall’s service desk told the reporter. “The mall has 9 floors and covers an area of nearly 80k square meters.”

“Easy to find and easy to use” AEDs have become an urgent need

In 2021, the National Health Commission issued the Guidance for the Allocation of Automated External Defibrillators in Public Places (Trial) (hereinafter referred to as the “Guidance”), which makes detailed provisions for AED deployment. The Guidance clearly states that the installation of automated external defibrillators should follow the principles of scientific planning and focusing on practical effectiveness, prioritizing key public venues, and increasing deployment density.

“With the public’s awareness of emergency care increasing, AEDs that are ‘easy to find and easy to use’ have become a pressing public service need.” Zhang Qihua said. “However, currently China does not have nationwide unified mandatory regulations for the required allocation of AEDs in public places. That said, in cities such as Hangzhou, Shanghai, and Chengdu, relevant management measures have already been introduced, providing a reference for other areas.”

“AED deployment in public places should be based on the standard of ‘quick access within 3 to 5 minutes.’ Meanwhile, for high-risk public venues, AEDs can be prioritized for placement, standardized labeling and maintenance, and staff training can be strengthened.” Yuan Lin said.

“Local authorities can connect information such as AED locations, status, and maintenance records to information-sharing platforms, and promote interconnection between these platforms and mobile navigation software and the 120 dispatch command system. This would enable functions such as real-time AED location, status inquiries, and navigation guidance, so the public can quickly find the nearest available AED.” Zhang Qihua said.

In addition to being “findable,” AEDs also need to be “usable.” “It is recommended to clearly define mandatory training obligations for staff in certain public venues, expand the coverage of training, improve public emergency care awareness, and ensure that AEDs can truly be put to use when it matters most.” Zhang Qihua said.