3.4.1 Findings from the 2004 reviewThe 2004 review identified a number of risks associated with the provision of AEDs in PAD programs. The primary risk identified was legal in nature.
A study of a PAD program in the UK identified the possibility of threats of legal action for lay-people who use AEDs. In UK law at the time, no protection was provided for lay-people such as 'Good Samaritan' legislation. However, the risk of legal action was seen to be minimal.
The review concluded:
Little information is available that outlines specific risks associated with the broad implementation of PAD … The experience of the initiative undertaken in the United Kingdom and trial data from the USA would suggest that implementation of broad based PAD programs are feasible and the risks manageable (Jacobs 2004, P.22).
3.4.2 Update: evidence published since 2004AEDs are noted for their safety and reliability, particularly with advancements in technology in the past years.
However, as with any complex electronic device, AEDs can be prone to error and failure. In an American study, Shah et al. (2006) examined AED recalls and safety alerts to estimate the rate of failure and malfunctions for AEDs. The study included 775,539 AEDs sold between 1996 and 2006. Key findings of the study included the following:
- Actual malfunctions and failures of AEDs were reported to be very low, the risk of failure was estimated to be less than 1%
- The number of recalls of AEDs was far higher at 21%. Recalls were most commonly done as a result of known hardware weaknesses. Errors due to software were less common
- The study identified 370 instances of fatal AED device malfunctions.
… the total number of malfunctions is small compared with the number of lives saved (p. 658).
A study published in Austria cites a risk associated with AEDs that may be relevant to the Australian context. Schlimp et. al. (2004) suggested that interference from high-voltage power-lines may affect the functioning of AEDs. Schlimp noted that AEDs operated near such power-lines were at an increased risk of failure due to the high electrical charge interfering with the devices’ ability to detect and analyse rhythms prior to shock. This interference was reported to have the potential to cause substantial harm to patients. The study concludes:
The proper function of AEDs needs to be reconsidered to guarantee patients' safety near high-voltage power lines (P. 595)
It should be noted that the high-voltage power line system in Austria may differ to that in Australia, and the results of this study can not necessarily be applied in the Australian context.