AED use in nursing homes has come under increased scrutiny following new research on survival outcomes and emergency response practices. A recent article published in McKnight’s Long-Term Care News, “Basic life support tools underused for cardiac events at US nursing homes: study”, highlights an eight-year study where researchers found that while 82% of residents received CPR during cardiac events, only 28% received an AED application.
When cardiac arrest occurs, the rate of survival diminishes by about 10% for every minute between the arrest and the initiation of CPR. Recent studies have shown improved outcomes when cardiac arrest is witnessed and CPR is initiated using an AED. But should AEDs be standard in senior living communities? Beyond clinical outcomes, AED use in nursing homes raises important questions about staff capacity, cost-effectiveness, and whether the intervention aligns with resident care goals.
Two additional articles further explore this issue. A recent study in JAMA Network Open found that AEDs were associated with better outcomes in some community settings, but the same benefits didn’t clearly extend to long-term care environments—largely due to delayed response times and unwitnessed arrests. Another article from Caring for the Ages, “The AED Dilemma in Long-Term Care”, discusses how these devices intersect with goals-of-care discussions, especially in communities where comfort measures or palliative care may take priority.
At the end of the day, CPR is a worldwide practice, and an AED may be a valuable addition to your community’s emergency preparedness plan. That said, my experience is that very few (if any) cardiac arrests in senior living communities are actually witnessed. Too often, staff may not be aware a resident has experienced a cardiac event for several minutes or more. The most important thing we can do is honor our resident’s wishes regarding emergency care. Be sure medical records clearly reflect code status, advance directives, and—if you’re really on it—advance care planning documents.
Stay well and stay informed!
