The public access market is, by far, the fastest growing sector of the defibrillator industry. Frances Penwill-Cook looks at how these life-saving machines are adapting for use by both professionals and amateurs.
Quick response is vital to surviving a heart attack. The chance of surviving sudden cardiac arrest decreases by 7–10% with every minute that passes, but can be reversed if an automatic external defibrillator (AED) delivers a shock to the heart within a few minutes. For many, having these portable devices stored in public institutions is the difference between life and death.
The manufacture of a wide range of AEDs has meant that not only are hospitals and medical centres equipped to deal with emergency cardiac situations, but the public access market segment (schools, churches, restaurants sports and entertainment venues and so on) are too.
Designs of varying sizes, weights and operating features mean that both the highly trained professional and the layperson can now operate an AED device. The public access market now outstrips all others and with half a million defibrillators deployed worldwide, is an increasingly attractive business segment.
AEDs for trained responders
For professional responders, law enforcement officers and designated response teams in the police, workplace or schools, it is necessary that AEDs are designed for ruggedness as well as ease of use. Philips HeartStart FRx (height 6cm, width 22cm, depth 18cm) weighs just 3.5lbs or 1.5kg and is created with these factors in mind, as are the HeartStart FR2+ defibrillators.
"The clean, uncluttered design is optimised for fast, efficient operation and rapid delivery of life-saving therapy and is engineered to a military standard," says Jamie Froman, director of marketing for HeartStart Automated Defibrillators at Philips Healthcare.
Defibrillators designed for non-hospital use must undergo intensive testing to ensure durability.
Froman says that for Philips this entails: 'Dropping the devices from over a metre onto a concrete floor and spraying the device with strong water jets to be sure that it can withstand harsh environments."
The benefits of automated defibrillation have been so significant that even NASA at its International Space Station (ISS) has chosen an AED, Physio-Control's Lifepak 1000, over a manual product. Its size (height 8.7cm, width 23.4 cm, depth 27.7cm) and weight (7.1lbs/3.2kg) minimise hardware mass and volume onboard. It also requires less training and maintenance, optimising response outcomes from its crews.
"The Lifepak 1000 defibrillator is the most rugged defibrillator ever designed by Physio-Control," says Cam Pollock, vice president of marketing at Physio-Control. "It is equipped with cprMAX technology, and provides an upgradeable platform so care providers can change protocols as standards of care change."
Professional emergency responders
AEDs targeted towards professional responders, trained in life support, combine more complex features. They usually offer both manual and automated functionality and are generally larger and heavier than the models designed to serve the lay person.
Physio-Control's Lifepak 20 model (height 21.3 cm, width 26.2cm, depth 26.2cm) is designed for responders trained in basic life support, nurses and those trained already trained in the use of defibrillators.
Philips' HeartStart MRx monitor and defibrillator combines monitoring technology with diagnostic measurements and has been designed to meet the technical and harsh environmental demands of advanced professional emergency responders.
Weighing in at 13.2lbs (6kg) and with larger dimensions (height 31.5cm, width 29.5cm, depth 21cm), the device transmits real-time, 12-lead electrocardiogram (ECG) data via wireless technology to better prepare physicians before patient arrival.
This model is able to defibrillate quickly using Philips patented SMART biphasic defibrillation therapy.
"It is a one-of-a-kind tool offering a complete, integrated CPR real-time measurement and feedback solution designed to encourage rescuers to deliver CPR in accordance with European Resuscitation Council and American Heart Association guidelines," says Froman.
AEDs for lay responders
For lay responders the priority has to be ease-of-use and portability, to allow quick response. The HeartStart OnSite (weighing just 3.3lbs/1.5kg) and the Home Defibrillators models from Philips are the smallest, lightest devices in its product line, designed to sense and adapt to the user's actions. "They are designed for exceptional ease-of-use to help give lay responders the power to save a life," says Froman.
Physio-Control's LIFEPAK CR Plus and LIFEPAK EXPRESS were also created for the lay responder. Although more user-friendly through offering instruction, they also contain the same advanced defibrillation technology used by the emergency services.
Defibtech has experienced great success in this particular market, with more than 70,000 of its AEDs chosen because of their clean, user-friendly design.
This model is drop-tested to US military "drop and shock" specifications and has proven durability. At 4.2lbs and with user-friendly, bright and over-sized buttons, it is designed to help nervous users with a step-by-step guide.
"Since sudden cardiac arrests can occur anywhere, we've designed the unit to be brightly coloured with rubberised grips contoured to the hand," says Greg Slusser, vice-president at Defibtech.
"Defibtech, from its inception, has specialised in defibrillators for the market segment where users are likely not to be medical professionals," adds Gintaras Vaisnys, Defibtech's president.
One step ahead
With the AED market growing and competition fierce, it is essential that the manufacturers get the product right and market it in the best possible way. Identifying distribution channels is one of Defibtech's priorities. "Our success has been achieved through careful targeting of the many distribution channels that are positioned to serve these vast public access markets, which will continue to outpace the overall market growth for AEDs by a factor of 4:1," says Slusser.
One of Physio-Control's priorities is to monitor feedback from product users such as firefighters, paramedics and nurses. Its close business partnerships also enable it to incorporate the latest monitoring functions.
As a Global Fortune 500 company, Philips has access to top suppliers and designers. Due to the number of defibrillators deployed across the world – over 500,000 – it is able to sustain strong relationships with its manufacturers in key areas such as microchips, high-voltage components and plastics.
More than 70% of sudden cardiac arrest (SCA) victims who are defibrillated within two minutes survive. It is this type of statistic that is driving demand from the public access market segment along with positive changes in legislation.
"More countries are seeing the value of implementing early defibrillation programmes in the business-to-business and community access sectors," says Froman.
"For example, legislation that helps enable the spread of early defibrillation programmes has been enacted in a wide range of countries in the last 12 months, including France, Korea, Israel and Dubai."
With AEDs proving their worth as survival rates rise to between 30% and 40%, and with worldwide demand growing as implementing early defibrillation schemes take hold, the AED market is likely only to become more profitable and competitive.