The science and tech stories with the largest impacts are rarely found in cutting-edge journals or trade magazines. Often, they’re advancements and discoveries that were first realised years, if not decades ago. Technology impacts happen when paradigm-shifting tools reach the people and institutions that can use them effectively.
One technology already at this stage is the Automated External Defibrillator (AED). A portable and automated technology available for decades now — these machines have only just begun to reach widespread adoption. Yet, they already save thousands of lives every year. Even still, greater advances exist for the future of these machines.
You have, most likely, already seen these devices in public locations. Trains stations, airports, and sports facilities regularly have brightly coloured devices prominently signposted and ready for use in an emergency. Despite being developed in the late-1970s, the machines themselves have only recently reached a point of affordability and maintainability that have made them practical for use in public locations.
In the short time since the devices have become widely available, they’ve already had an outsized impact. In the United States alone, the devices are estimated to save some 1,700 lives per year. With additional public training, better awareness, and more devices, that number could grow dramatically in a short period of time.
Effects of Today’s Widespread AED Deployment
AEDs applied by bystanders have already been shown to be an extraordinarily effective intervention in a cardiac event. Even without training, the application of an AED has been shown to make an impactful difference to both survivability and outcomes.
In one study, patients were shown to be 20% more likely to survive and 25% more likely to a positive outcome with the intervention of an AED. Used in the workplace, at school, or within a sports facility — the impact of an operational AED and trained personnel to use it can be even greater still.
Of course, there will always be certain elements of chance and fortune to being near enough one such device to have a meaningful impact and having a close enough to a bystander willing to intervene. Both of these probabilities can be influenced by deploying more devices and improving awareness around the increasingly present dayglo machines.
As the unit cost of these devices comes down and awareness ramps up, the chances of catching just a little good fortune get ever so slightly greater over time. Teaching the wider public how to use them becomes the next hurdle to overcome.
How an AED Works
TV medicine has misrepresented what defibrillators are and what they do perhaps more than any other single device or technique. Despite what Grey’s Anatomy or ER might have you believe — it’s far from a semi-magical piece of kit designed to restart a completely stopped heart.
When there’s no electrical activity to be found, a defibrillator in real life can do nothing at all. Reviving a ‘flatline’ ECG might make for great TV drama, but it’s a serious stretch of reality.
The role of a defibrillator isn’t to restart electrical activity but to “fix” a heart rhythm that’s too slow, too fast, or simply out of sync. An AED can detect this automatically, deciding if and when it should provide the patient with a shock for the best chance at restoring a regular pulse.
A secondary myth that follows these devices is that they replace “old-fashioned” CPR in an emergency. This is simply not true. Bystanders should do CPR first and foremost in an emergency situation. Even where mouth-to-mouth breathing isn’t an option, chest compressions alone are an effective life-saving intervention and the best thing you can do.
Many AED machines are equipped to provide audio instructions to assist bystanders in performing effective CPR. Automation allows the device to issue detailed instructions to stop and resume as the device performs interventions as and when it can. Perhaps the most effective and most powerful feature of these devices is that they need no specialist knowledge and only the most minimal of bystander assistance to deliver effective aid.
Effects of an AED
More than 60% of public cardiac arrests today are events that can be impacted by the use of an AED. Currently, a bystander intervenes to deliver a shock in almost 20% of these cases. Improving availability and information surrounding these devices can and should bring this number up sharply.
The result of having widespread and easily accessible AEDs can be staggering. One study showed that cardiac events covered by an accessible AED were nearly twice as likely to achieve 30-day survival. The odds of achieving a favourable outcome for recovery rise just as dramatically.
Worldwide, there are some 17 million deaths associated with cardiac disease every year. As The leading cause of death for over two decades, it’s a prime target for both healthcare and technology to deliver changes and solutions that can have maximum impact.
The Costs of an AED
For decades after the development of the first AEDs, the costs of the machines stood in the way of widespread adoption. It took many years, continual refinement, and gradual progress before they became visible in public throughout the 2000s.
In such relatively simple machines, a slow pace of development and high cost of purchase can seem surprising. The costs associated with an AED, however, are held primarily in the research, development, and regulations that goes into such a critical life-saving tool.
Building a machine that can deliver an electric current is indeed easy. Delivering a device that can detect and intervene after sitting semi-dormant for years and provide guarantees about its own performance in a life or death situation is an engineering challenge few have the stomach to wrestle with.
The minimum cost of developing a ‘moderate risk’ medical device today starts at around $30 million.
Once invested, however, these costs don’t tend to return in any meaningful way. Companies are free to recoup their initial vast investment year after year without making significant changes to the product itself. This is a stage AEDs find themselves in now.
Costs associated with the early development of the devices have been slowly recouped since the 1980s. As a result, the devices have gradually lowered in price. Today, they’ve reached a point where they are widely available in public spaces and increasingly installed in private businesses.
A new device can now be purchased for around £900 ($1,200). The price tag may be within the range of a mid-sized employer or facility, but it’s still outside the budget of most homes. The next stage of the development for these devices is likely to lead to one more great shift in healthcare tech.
AEDs are rapidly making their way into the same space as smoke detectors, fire blankets, and extinguishers. Each are lightweight life-saving appliances that have been widely available for some time now. In many cases, these appliances are now legally required for rented or private accommodation.
While AEDs will only ever apply to a certain percentage of use-cases and scenarios, those that live with someone able to use them, for example, the effects they can have when applied will make them more than worthy of a more reasonable investment in the future.
Smart, patient-led health Devices are the Future of Healthcare Tech
Smart devices are already putting healthcare responsibility into people’s hands. While most homes may have had little other than a bathroom scale 20–30 years ago, today’s technology turns that picture on its head.
Affordable and dependable healthcare tech available for the home today includes blood pressure cuffs, glucose monitors, body fat analysers, oxygen saturation devices and a host of other machines that would previously been available only in a medical environment.
The current picture of healthcare today is rapidly changing for the better. This change is being driven first and foremost by technology.
Interconnected with our phones and devices, these tools enable people to track, monitor, and change their healthcare decisions with the abundant information, resources, and expert advice available.
This dramatic shift has the power to deliver life-altering positive interventions at a point that would have previously been impossible. AEDs and technology that can intervene to assist with critical care is the next major paradigm shift to happen within healthcare tech. Lowering costs and increasing availability are the next steps towards realising this goal.
Simply placing the technology in the hands of the people and institutions that can use them will have an extraordinary impact on lives. With better awareness, training, and availability, we can amplify these impacts into something even greater still.
