How to Master AED Placement: A Facility Manager’s Step-by-Step Guide
Did you know that every minute without AED intervention decreases a cardiac arrest victim’s survival chance by 7-10%?
That’s why proper AED placement stands as one of the most critical decisions we face as facility managers. In fact, when an AED is used within the first 3-5 minutes of cardiac arrest, survival rates jump from 6% to over 74%.
However, many facilities still struggle with optimal AED placement, creating dangerous gaps in emergency response coverage. As someone who has helped countless organizations optimize their emergency preparedness, I know the challenge of balancing coverage areas, response times, and budget constraints.
In this guide, I’ll walk you through the exact steps to determine where your AEDs should go, how many you need, and how to install them correctly. Let’s make sure your facility is prepared to save lives when every second counts.
Understanding AED Response Time Requirements
Time is the most precious resource during a cardiac emergency. The scientific evidence is clear: proper AED placement dictates how quickly responders can reach and treat a victim of sudden cardiac arrest (SCA).
Why the 3-5 minute rule matters
The 3-5 minute response time isn’t arbitrary—it’s based on extensive medical research about cardiac survival. According to the American Heart Association, effective AED programs are specifically designed to deliver a shock to a victim within three to five minutes after the person collapses [1]. This timeline represents the critical window during which defibrillation offers the greatest chance of successful resuscitation.
What makes this timeframe so important? During cardiac arrest, the heart’s normal rhythm is disrupted, preventing blood from circulating to vital organs. The brain, especially sensitive to oxygen deprivation, begins to suffer permanent damage after just 4-6 minutes without blood flow [1]. Therefore, every facility’s AED program should aim to ensure that a person in cardiac arrest receives help as soon as possible—ideally within that 3-5 minute window [2].
How response time affects survival rates
The relationship between response time and survival is stark and undeniable. For every minute that passes without defibrillation, a victim’s chance of survival decreases by 7-10% [1][2]. This dramatic decline explains why placement of AEDs becomes literally a matter of life and death.
Consider these sobering statistics:
- After 10 minutes without defibrillation, resuscitation rarely succeeds [2]
- Overall survival to hospital discharge is only 7% for all cardiac arrest victims [3]
- When an AED is applied, survival jumps to 24% [3]
- When an AED shock is delivered, survival rates reach 38% [3]
Perhaps most compelling, a study of casino security officers found that when defibrillation occurred within 3 minutes of witnessed collapse, the survival rate reached an impressive 74% [4]. Conversely, when defibrillation occurred after 3 minutes, survival dropped to 49% [5].
Calculating actual vs. ideal response times
Determining whether your facility meets the 3-5 minute standard requires understanding all components of response time. The total response interval includes:
- Recognition time (approximately 1 minute): The time it takes for someone to recognize the emergency and decide to get an AED [6]
- Retrieval time (should be 1½ to 2½ minutes): The time needed to reach the AED [2]
- Return time (should be 1½ to 2½ minutes): The time needed to bring the AED back to the victim [2]
- Application time (approximately 1 minute): The time required to turn on the AED, apply pads, and deliver a shock [6]
To test your actual response times, conduct timed drills during normal operating hours. An able adult typically walks briskly at about 300 feet per minute [1]. Start at your AED location and walk for 90 seconds—this represents the maximum distance a responder should need to travel to reach a victim [1].
Remember that theoretical calculations often differ from real-world conditions. Physical barriers, crowded hallways, multiple floors, or locked doors can significantly delay response [4]. Additionally, the median EMS response time is 5.3 minutes [3]—which already pushes past the ideal window, making on-site AEDs essential.
By thoroughly assessing your facility’s actual response capabilities, you can identify gaps in coverage and make informed decisions about optimal AED placement.
Assessing Your Facility’s Layout
Proper AED placement begins with a thorough evaluation of your facility’s physical environment. Unlike theoretical calculations, real-world layouts contain unique challenges that affect emergency response times.
Mapping your facility’s floor plan
The first step in AED placement involves creating a detailed diagram of your entire facility. This map serves as the foundation for all subsequent decisions about where to position your devices. Start by obtaining building blueprints or floor plans that show all rooms, hallways, stairwells, and exits. For facilities spanning multiple buildings or outdoor areas, your map must extend beyond the main structure to include parking lots and auxiliary spaces [7].
Mark all existing emergency equipment, evacuation routes, and gathering areas on this map. Furthermore, note areas that require special access credentials, as these become critical factors in emergency response scenarios [3].
Identifying high-traffic areas
AEDs should be strategically placed near locations where people congregate, as these represent statistical hotspots for cardiac emergencies. Look for:
- Areas with high occupant density such as cafeterias, auditoriums, and reception areas [8]
- Places where physical exertion occurs, like gymnasiums or workout rooms [9]
- Main entrances and central corridors [8]
- Assembly lines or areas where many employees work in close proximity [7]
Research shows that placing AEDs in visible, high-traffic areas significantly increases the likelihood they’ll be accessed quickly during an emergency. Equally important, consider temporal aspects of your facility usage—many buildings have limited access to certain areas during evenings and weekends [10].
Locating physical barriers and obstacles
Walking routes in real-world settings rarely follow straight lines. Studies reveal that real-world travel routes to the nearest AED are typically 219-222 meters longer than straight-line estimates in urban environments [1]. Consequently, your assessment must identify obstacles that could delay response:
- Stairwells and elevators
- Locked doors or security checkpoints
- Cubicles, desks, and office furniture
- One-way door access points
- Areas with consistently heavy foot traffic [3]
Building accessibility changes dramatically throughout the day. In one study, temporal AED accessibility affected coverage significantly, with the largest coverage loss occurring at night [10].
Measuring walking distances between key points
The most reliable method for determining optimal AED placement involves physically walking your facility with a stopwatch and building diagram [8]. Begin this process by:
- Choose an initial central location for potential AED placement
- Travel to the farthest point in your facility from this location
- Time yourself walking at a brisk pace (approximately 100 meters per minute) from this point to the proposed AED location [1]
- Double this time to calculate the round-trip response time
- Repeat this process from different distant points throughout your facility [3]
The goal is ensuring no point in your facility requires more than 90 seconds of one-way travel time to reach an AED [5]. Remember that a 90-second retrieval plus 90-second return plus time for recognition and application should remain within the critical 3-5 minute window.
Studies comparing straight-line distance calculations to actual walking routes found that the identity of the nearest AED changed in 26% of cases when accounting for real-world travel routes [1]. This explains why physical assessment is essential—mathematical models simply cannot account for all real-world variables.
Calculating the Number of AEDs Needed
After assessing your facility’s layout, determining exactly how many AEDs you need becomes the next critical step. Having the right number of devices strategically positioned throughout your building directly impacts survival outcomes during cardiac emergencies.
Using the square footage formula
The most common method for calculating AED quantities starts with your facility’s total square footage. The standard recommendation is one AED for approximately 20,000 square feet of floor area [11]. This formula provides a baseline for adequate coverage across most facilities.
For large, open facilities, another approach measures coverage radius. Since an average person travels about 150 feet per minute during an emergency, an AED can effectively cover roughly 70,000 square feet [12]. However, this calculation assumes unobstructed pathways and open floor plans.
Remember that square footage calculations serve as starting points rather than absolute rules. The primary goal remains ensuring no location in your facility is more than 1.5 minutes away from an AED [11]. Thus, a facility with complex layouts might require more devices despite lower square footage.
Adjusting for multiple floors
Multi-story buildings present unique challenges for AED placement. The general guideline recommends approximately one AED every two floors of a multi-story building [11]. For tall commercial or residential buildings, many experts suggest one AED per floor to maintain the 90-second retrieval rule [13].
Some buildings follow more specific formulas. For instance, university buildings often implement a policy of one AED device per every two floors [14]. In a six-floor building, this translates to three strategically placed AEDs. Buildings with odd numbers of floors typically round up for coverage purposes (a five-floor building would still need three AEDs) [14].
Vertical travel time significantly impacts response—stairs and elevators dramatically slow AED retrieval. Moreover, elevators may be unavailable during emergencies, making stairwell access the only option and further extending response times.
Accounting for special risk areas
Beyond standard calculations, certain locations demand additional AED coverage due to elevated cardiac arrest risk:
- Fitness areas and gyms: Exercise-related cardiac events occur more frequently in these spaces [3]
- High-volume gathering spots: Auditoriums, conference rooms, and cafeterias where large numbers of people congregate [3]
- Areas with strenuous activity: Manufacturing floors, loading docks, or facilities with physical labor
- Senior living sections: Spaces primarily occupied by elderly individuals
The stakes are incredibly high—if someone receives AED assistance within one minute of collapse, they have a 90% chance of survival [15]. Each additional minute that passes reduces survival odds by 10% [15].
When your calculations yield borderline results, always err on the side of additional coverage. The cost of an extra AED pales in comparison to the potential cost of inadequate emergency response time.
Selecting Strategic AED Locations
Strategic AED placement can mean the difference between life and death during cardiac emergencies. Now that you’ve determined how many devices your facility needs, let’s focus on exactly where to position them for maximum effectiveness.
Prioritizing high-visibility areas
AEDs must be immediately visible to anyone in your facility. The number one rule for effective AED placement is visibility [16]. While it may be tempting to protect expensive equipment by tucking it away, this defeats the purpose entirely.
The most effective locations include:
- Main entrances and lobbies
- Near elevators and stairwells
- Adjacent to frequently used gathering spaces like cafeterias and meeting rooms
- Close to high-occupancy work areas such as assembly lines [17]
Clear signage is essential—never let esthetic concerns override safety. Professional AED signage with universally recognized symbols should mark both the device location and provide directional guidance throughout your facility [18]. Ideally, responders should be able to assist an SCA victim in less than two minutes [18]. Wall-mounted 3D signs placed above AEDs enable responders to spot devices across large rooms, similar to identifying emergency exits [3].
Ensuring 24/7 accessibility
Notably, one in five cardiac arrests occurs near an inaccessible AED [10]. Many facilities place AEDs in locations that become inaccessible outside regular working hours, with availability decreasing up to 60% during nighttime and weekends [19]. This creates a serious gap in emergency response capability.
To address this issue, consider:
- Mounting AEDs in outdoor, weatherproof cabinets that remain accessible at all times [19]
- Installing devices at transportation hubs or other 24/7 operational facilities [19]
- Using cabinets with security features like alarms and lighting to deter vandalism [19]
- Ensuring AED positions are well-lit and potentially video-monitored [19]
For maximum accessibility, mount AED cabinets 48 inches above the floor in unobstructed areas [18]. This ensures wheelchair accessibility while allowing anyone to remove the device with one hand to minimize response time [16].
Avoiding placement near electrical interference
Although often overlooked, electrical considerations must factor into your AED placement strategy. Facilities managers should avoid positioning AEDs near sources of electrical interference [16]. This includes high-voltage equipment, powerful motors, or areas with significant electromagnetic activity.
Additionally, be strategic about placement in relation to other emergency equipment. Many experts recommend installing AEDs near existing emergency resources like fire extinguishers or first aid cabinets [20]. This creates intuitive "safety zones" that responders can quickly locate during emergencies.
Ultimately, your AED placement must balance visibility, accessibility, and technical considerations. By thoughtfully addressing each factor, you’ll create an emergency response system that truly saves lives when every second counts.
Installing AEDs Properly
Once you’ve determined optimal locations, proper AED installation is the crucial next step. The physical placement of these devices must follow specific guidelines to ensure accessibility when seconds count.
Following ADA height and projection guidelines
The Americans with Disabilities Act (ADA) provides explicit rules for installing life-saving equipment. First of all, height requirements mandate that AED handles must be mounted no higher than 48 inches from the floor [2]. This ensures accessibility for individuals with disabilities while keeping devices within reach of the general population [21].
Projection guidelines are equally important. Objects projecting from walls with leading edges between 27 and 80 inches above the finished floor shall extend no more than 4 inches into walkways, halls, corridors, or passageways [3]. These specifications prevent AED cabinets from becoming obstacles in emergency evacuation routes.
Installing clear signage and wayfinding
Clear signage is as important as the AED itself. I recommend installing a three-dimensional universal AED sign above each device [22]. These projecting signs enable responders to spot AEDs across large rooms—similar to identifying emergency exits—which saves precious time during emergencies [2].
Additionally, post directional signs that indicate the path and distance to the nearest AED [2]. These wayfinding markers should be visible from at least 200 meters away with lettering approximately 5 inches high [2]. For outdoor or nighttime access, illuminate your AEDs with supplemental lighting [2].
Remember to inspect signs at least annually and replace any damaged markers [2]. California specifically requires visible signage with clear instructions about AED locations, plus usage instructions posted next to devices in at least 14-point font [23].
Creating an AED location registry
Registering your AEDs completes the installation process. Register each device with:
- Your state or local EMS system (required in 40 states) [4]
- The device manufacturer for maintenance notifications [6]
- Free registry services like PulsePoint AED [24]
These registrations provide critical benefits. The manufacturer will send reminders about battery replacements, electrode expirations, and potential recalls [6]. Meanwhile, EMS registration allows 911 dispatchers to direct callers to the nearest AED during emergencies [24].
Store registration information where multiple current staff members can access it, and include it in your organization’s emergency safety plan [2]. This ensures continuity regardless of staff turnover.
Conclusion
Proper AED placement stands as a cornerstone of effective emergency response systems. Through careful planning and strategic positioning, facility managers can significantly boost survival chances during cardiac emergencies.
Remember that successful AED programs depend on three key factors: response time optimization, strategic device placement, and proper installation protocols. Each minute saved through thoughtful AED positioning directly translates to higher survival rates.
For those seeking additional knowledge about emergency medical equipment, I recommend exploring "Defibrillators Demystified – Understand the different types and their life-saving applications across various medical settings."
Most importantly, maintain regular checks of your AED locations, signage, and registration status. Update your facility’s emergency response plans as needed, and ensure all staff members know exactly where to find these life-saving devices. After all, a well-planned AED system not only meets regulatory requirements – it saves lives when every second counts.
FAQs
Q1. How many AEDs should a facility have?
The number of AEDs needed depends on your facility’s size and layout. A general guideline is one AED for every 20,000 square feet of floor area. However, ensure that no location in your facility is more than 1.5 minutes away from an AED. For multi-story buildings, consider having one AED every two floors or one per floor in taller structures.
Q2. Where is the best place to install an AED?
AEDs should be installed in high-visibility, easily accessible areas. Ideal locations include main entrances, lobbies, near elevators and stairwells, and close to high-occupancy work areas. Ensure 24/7 accessibility and avoid placing them near sources of electrical interference. Mount AEDs at a height of 48 inches above the floor to comply with ADA guidelines.
Q3. How does AED response time affect survival rates?
AED response time is crucial for survival. For every minute that passes without defibrillation, a victim’s chance of survival decreases by 7-10%. When an AED is used within the first 3-5 minutes of cardiac arrest, survival rates can increase from 6% to over 74%. This emphasizes the importance of strategic AED placement for quick access during emergencies.
Q4. What signage is required for AED installations?
Clear signage is essential for effective AED use. Install three-dimensional universal AED signs above each device, visible from at least 200 meters away. Use directional signs to indicate the path and distance to the nearest AED. For outdoor or nighttime access, provide supplemental lighting. Some jurisdictions, like California, have specific requirements for AED signage and usage instructions.
Q5. How often should AED placements be reviewed?
While there’s no universal rule, it’s advisable to review AED placements regularly, especially when there are changes to your facility’s layout or occupancy. Conduct annual inspections of AED locations, signage, and registration status. Update your facility’s emergency response plans as needed, and ensure all staff members are familiar with AED locations and usage protocols.
References
[1] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8592858/
[2] – https://cpr.heart.org/-/media/CPR-Files/Training-Programs/AED-Implementation/2023-updates/KJ1683-AED-Guide.pdf
[3] – https://www.avive.life/blog/aed-placement-best-practices
[4] – https://www.cdc.gov/cardiovascular-resources/php/pad-slfs/index.html
[5] – https://aedauthority.com.au/wp-content/uploads/2021/05/AED_Site_Assessment_eBook.pdf?srsltid=AfmBOoqPLVvHon_R8fL49Gj7EpKumm-kBvWoNhG99NUIbrmr2DRNFS4m
[6] – https://www.nationalaedregistry.com/register/?beginregistration=
[7] – https://www.aed.com/blog/finding-the-best-location-for-your-aed/?srsltid=AfmBOopsqInlrfDf92uH9IWVXtdaH0wv6-ZtC6_5CraDmvyjW8OfVkpf
[8] – https://kcfirstaid.com/aed-site-assessment/
[9] – https://www.aed.com/blog/where-should-i-place-my-aed/?srsltid=AfmBOoqE0ny5qlg3QpwLt8Dr0p6cptGbdX8ny39v6QTMYcDCYKLU7O-F
[10] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4992180/
[11] – http://budget.harriscountytx.gov/doc/RM/AED_County_Program.pdf
[12] – https://www.aed.com/blog/aeds-at-work-factories-warehouses-and-industrial-environments/?srsltid=AfmBOop-YpO6jyJ02UrqKmL9vqFvZupKb-bLFS6wdMGvouVFncm2-4iD
[13] – https://www.aedbrands.com/aed-calculator-how-many-devices-do-you-need/?srsltid=AfmBOopBKY8DchOK4D6n2G1Uk_hp18K-C8XB1IMv-lDqAgASGfa_ramk
[14] – https://emergencymanagement.utexas.edu/sites/default/files/documents/Complete_with_DocuSign_OEM_AED_01_Automated_.pdf
[15] – https://aedsafety.com/aed-calculator-how-many-aeds-do-i-need
[16] – https://www.aed.com/blog/finding-the-best-location-for-your-aed/?srsltid=AfmBOooHQi9tOot8LdvGgImNxY0bFzTTKu8zgsHFyWSsCZ4uUyUbdcTd
[17] – https://readisys.com/aed-program-best-practices-guide/
[18] – https://www.aed.com/blog/finding-the-best-location-for-your-aed/?srsltid=AfmBOorgLVmS1NLD0DLYKUAcd2tyvcwym8unzxALk564nrQW-Mb2Lpo4
[19] – https://www.resuscitationjournal.com/article/S0300-9572(25)00026-7/fulltext
[20] – https://hsi.com/blog/aeds-in-the-workplace-placement-and-management-tips
[21] – https://static.www.nfl.com/league/causes/smart-heart/Guidelines_for_Placement_and_Installation_of_AEDs.pdf
[22] – https://parentheartwatch.org/wp-content/uploads/2017/02/Guidelines-for-AED-Installation.pdf
[23] – https://www.avive.life/blog/aed-signage-requirements
[24] – https://www.pulsepoint.org/pulsepoint-aed