AED: what it is and what has changed after the decree of March 16, 2023

This week's article is entirely focused on AEDs, automatic and semi-automatic external defibrillators - medical devices that can save many lives.

Welcome back to the PVS blog!

 

This week’s article is entirely focused on AEDs, an acronym used to indicate automatic and semi-automatic external defibrillators.

 

Let’s start with a technical definition of a defibrillator. A defibrillator, whether manual, semi-automatic, or implantable, is considered a medical device used to defibrillate a patient in cardiac arrest or ventricular fibrillation – therefore in a life-threatening situation. The defibrillator is able to deliver an electrical shock directly to the patient’s heart and limit the damage of a potentially fatal arrhythmia or cardiac arrest.

 

Automatic and semi-automatic external defibrillators, AEDs in fact, differ from manual ones because they have technology that automatically detects whether or not a direct shock to the heart is needed.

 

In recent decades, there have been many regulations and decrees in Italy regarding the mandatory presence and situations in which using AEDs was appropriate, if not mandatory.

 

The latest decree issued by the government, which we refer to in this article, dates back to March 16, 2023 and is titled “Definition of criteria and methods for the installation of semi-automatic and automatic external defibrillators, pursuant to Article 1, paragraph 3, of Law No. 116 of August 4, 2021 “. This latest decree follows the law of August 4, 2021, n. 166 which sets out all the directives for the use of AEDs in which, essentially, the obligation to have an AED device is established:

 

• at public administration offices with at least 15 employees and that provide services to the public (priority is especially given to schools of all levels and universities);

 

• in airports, train stations and ports, on board air, rail, sea transport and inland navigation that carry out routes with continuous travel, without the possibility of intermediate stops, lasting at least 2 hours;

 

• at public service providers and on extra-urban transport.

 

 

In short, this law promotes an increasingly widespread use of AEDs, as well as an ever-increasing presence of these life-saving devices. But what has changed since the decree issued on March 16, 2023?

 

 

The AED decree of March 16, 2023 in a nutshell

 

The aforementioned decree specifies the characteristics of installation, signage, and use of AEDs to create a widespread culture of their use and presence throughout Italy.

 

The decree consists of 2 attachments:

 

• Attachment A: describes installation methods and characteristics that AEDs must possess; • Attachment B: describes in graphic form the signage to be used for AED signaling.

 

In this part of the article, we examine the key points of Attachment A that we believe are important to know and highlight.

 

1. AEDs are necessary to monitor the automatic analysis of the electrical activity of the heart of a person who is a victim of cardio-circulatory arrest, therefore they should be placed in structures of any type, especially healthcare facilities (as per specific law).

 

2. The AED must always function correctly, and the electrical shock sent to the heart must be appropriate for each emergency case.

 

3. The electrocardiogram of the person who is subjected to the use of the AED must be recorded, as well as the data stored by the device.

 

4. AEDs should be distributed in a widespread and strategic manner across the territory, so as to be readily available and usable in case of emergency even before medical rescue vehicles arrive. For each installed AED, a person responsible for its proper functioning and user information must be appointed (Article 6, paragraph 2, of Law No. 116 of August 4, 2021). In populated areas, the optimal density of AEDs is not less than 2 AEDs/km².

 

5. AEDs must always be clearly visible, appropriately marked with signs/indicators, function perfectly, be turned on and tested frequently. It is mandatory to check their battery level and pads, test their internet connectivity via integrated Wi-Fi/SIM, and connect them to a remote monitoring system present in a 118 emergency call center (the geographically closest one).

 

6. The optimal placement of defibrillators is another crucial aspect. They should be roughly equidistant from each other, so that they can be retrieved and used in the shortest possible time. A timely intervention with an AED on a patient in cardiac arrest can really make a difference: it has been estimated that intervening within 4-5 minutes of a heart attack can save a life.

 

7. AED devices are mandatory on board 118 ambulances, medical rescue vehicles belonging to volunteer organizations (such as the Italian Red Cross, etc.), and Civil Protection vehicles, on all vehicles that can transport patients (including aircraft and ships). They must also be present on vehicles used by the State Police, Prison Police, Carabinieri, National Fire Brigade, Finance Police, Local Police, Alpine and Speleological Rescue, and Port Authorities throughout the territory.

 

 

If you want to know more about PVS AEDs and need further information on regulations and how to use these devices, use our dedicated form and contact us! We’ll be happy to help you.