If a public AED must be secured, why are we making a panicked bystander solve the lock?

This idea did not start with me.

And I want to make that clear right up front.

Like a lot of things in my world, it started with a conversation among friends and colleagues – in this case, John Chiaramonte and Erika Lakey – two respected colleagues I have worked with for years on public-safety technology, NENA initiatives, standards & best practices, and the occasional industry rabbit hole that turns into something much bigger than any of us anticipated.

We each tend to come at these discussions from slightly different directions.

That is usually what makes them interesting.

John recently wrote about sudden cardiac arrest and reminded people of something those of us in emergency communications already know, but the general public may not fully appreciate:

“A well-trained 911 professional is the first link in the chain of survival.”

John Chiaramonte, ENP • MISSION CRITICAL PARTNERS

He went on to point out that the 911 professional can get a caller performing CPR and help that caller locate an AED while responders are already on the way.

Erika brought YET another piece of operational reality into the conversation: having an AED nearby is only useful if someone can actually get to it when needed.

And somewhere while reading their exchange, my technology brain did what it normally does.

It asked:

Why does this problem have to exist?

More specifically:

Why are we treating AED security and immediate AED access as mutually exclusive?

That is where I want to pick up their conversation.

Not to take ownership of the problem they raised.

But to add another piece to it.

The AED Is Available – Until It Isn’t

Public-access AEDs present an interesting problem.

We want them visible.

We want them where people gather.

We want them outside buildings, at athletic fields, parks, transit locations, schools, shopping areas, municipal facilities, and other places where a sudden cardiac arrest might occur.

Most importantly, we want them available 24 hours a day, not merely during the hours when someone happens to have a key to the building.

But these devices cost real money.

So the minute someone suggests putting one outside in a publicly accessible area, somebody understandably asks:

What keeps it from being stolen?

What keeps it from being vandalized?

What keeps someone from tampering with it?

And eventually someone says:

Put it in a locked cabinet.

Which solves one problem…

and potentially creates another.

Research reviewed by the International Liaison Committee on Resuscitation found that theft and vandalism of AEDs were uncommon – generally below two percent in the studies examined – while simulation studies found that additional security measures, including locked cabinets, could slow AED retrieval. ILCOR consequently advises against locked cabinets for public-access AEDs. Where locking is unavoidable, its guidance is very clear: unlocking instructions must be obvious and access delays must be minimized.

That is an important point.

I am not advocating that we start locking AEDs that are currently freely accessible.

If an AED can safely remain unlocked and immediately available, terrific.

Problem solved.

But that is not the only real-world scenario.

What happens when concerns about theft, vandalism, liability, or control cause an organization to keep its AED inside instead?

Or behind a locked door?

Or available only during business hours?

Or perhaps convince the property owner not to install a publicly accessible device at all?

Now our security decision may have made the AED less useful to the community.

And this is where I think technology can help us stop arguing about which compromise is less bad.

We Already Put 911 in the Middle of This

Here is the part that makes this idea particularly interesting to me.

911 is already involved.

During a suspected cardiac arrest, the telecommunicator is not simply taking an address and dispatching an ambulance.

That professional may be providing CPR instructions.

They may be telling someone to send another person for an AED.

They may be helping identify where the nearest registered AED is located.

They are keeping the caller focused.

They are coordinating the response.

They are bridging the time between collapse and the arrival of professional responders.

So imagine this.

A caller reports that someone has collapsed at a public park.

The telecommunicator recognizes a potential cardiac arrest.

The system shows that a publicly accessible AED is located 150 feet away in a secured outdoor enclosure.

The telecommunicator tells another bystander:

“Go to the AED cabinet next to the concession stand. I’m unlocking it now.”

Click.

The cabinet releases.

The door opens.

The AED comes out.

And the telecommunicator continues guiding the rescue.

No searching for a key.

No reading a four-digit combination over the telephone.

No panicked person trying to remember whether the dispatcher said 6-3-9-2 or 6-9-3-2.

No breaking glass.

No waiting for someone from the building to arrive with access.

The emergency itself becomes the authorization.

And 911 becomes the trusted entity providing that authorization.

We Are Already Halfway There

Interestingly, the basic concept is not completely foreign to AED programs.

ILCOR’s review notes that some systems already use secured cabinets where the unlocking code is obtained by calling emergency services. That has the added advantage of helping ensure that EMS is activated, although the review also recognizes that obtaining and entering a code can itself introduce delay.

My question is:

Why stop at giving the caller the combination?

If the cabinet can be electronically controlled, why not allow the authorized 911 professional to release it directly?

We already understand this philosophy elsewhere in public safety.

For decades, fire departments have used controlled-access systems to gain emergency entry into buildings and secured areas without destroying a door every time they need access.

Modern electronic emergency-access systems take that further. For example, the Knox eLock platform demonstrates that electronic emergency access can be secured, electronically managed, and accompanied by an audit history recording system use.

I am not suggesting that a particular Knox product is the answer for AED cabinets.

I am pointing out that the functional concept already exists:

Secure something during normal conditions.

Allow authorized emergency access when needed.

Record that access.

Maintain accountability.

We know how to do this.

Make the Cabinet Part of the Emergency

Now we get to the piece that interests me most.

Don’t think of this as an AED cabinet with a fancy lock.

Think of the cabinet as another public-safety endpoint.

It has an identity.

It has a location.

It knows whether it is secure.

It can report whether the door opened.

It can potentially report whether the AED was removed.

And it can accept an authenticated emergency-access command.

The ECC should not need yet another screen sitting somewhere on a workstation with a username and password nobody remembers.

The capability should become part of the emergency workflow.

The cardiac-arrest event occurs.

The location is established.

An integrated AED registry identifies the closest appropriate device.

The telecommunicator directs the bystander toward it.

And an authorized function releases that specific enclosure.

Behind the scenes, the system records:

Which cabinet was accessed.

When it was accessed.

Which emergency event caused the request.

Who authorized it.

Whether the release succeeded.

Whether the enclosure was opened.

And potentially whether the AED was removed.

That is not technology for technology’s sake.

That is technology removing friction from an existing life-safety process.

And there is a huge difference between those two things.

Innovation Should Make the Problem Disappear

I have spent most of my career around communications technology.

I love technology.

Probably more than is healthy.

But one thing I have become increasingly intolerant of is deploying technology simply because someone invented it.

Public safety does not need another blinking box looking for a problem to justify its existence.

Innovation in public safety is not about using technology because it exists. It is about identifying an operational barrier and applying the right technology to make that barrier disappear.

The barrier here is pretty easy to understand.

We want an AED accessible to the public.

The organization responsible for that AED may want some reasonable level of protection and accountability.

Those objectives should not automatically be opposites.

So perhaps the answer is not simply:

LOCKED.

Or:

UNLOCKED.

Perhaps there is a third answer:

SECURED – but immediately accessible when 911 needs it.

That is the problem I am interested in solving.

This Needs to Be Faster Than a Combination Lock

There is an important design requirement hiding in all of this.

If our wonderful new technology adds thirty seconds, forty-five seconds, or a minute to retrieving the AED…

we failed.

Full stop.

The existing evidence gives us a warning here. Locked cabinets can create retrieval delays, which is precisely why international resuscitation guidance favors unrestricted access wherever possible.

So a remotely authorized enclosure cannot become an elaborate cybersecurity ceremony while somebody is in cardiac arrest.

We cannot have:

“Please wait while the cabinet authenticates to the cloud.”

Or:

“Your firmware update is 73 percent complete.”

Or my personal favorite:

“Unable to connect. Please contact your system administrator.”

No.

Life-safety technology has to fail intelligently.

There needs to be redundancy.

There needs to be a local emergency-access method.

There needs to be clear identification.

There needs to be monitoring.

There needs to be a procedure for communications failure.

There needs to be cybersecurity without making the human being experiencing the emergency solve the cybersecurity.

And the telecommunicator needs one simple operational action, not another application requiring six clicks across three monitors.

The goal is not merely remote unlocking.

The goal is faster access to defibrillation.

Everything else is engineering.

911 Becomes More Than the Voice on the Phone

There is another reason I like this concept.

It reflects where emergency communications is going.

For decades, 911 primarily received information.

Someone called.

Someone explained the emergency.

The telecommunicator gathered information.

Responders were dispatched.

But modern public safety is increasingly becoming bidirectional.

The ECC receives information from buildings, vehicles, sensors, cameras, devices, and people.

And increasingly, it can also influence what happens at the scene before responders arrive.

Unlock an AED.

Activate a warning.

Provide a floor plan.

Identify the correct entrance.

Notify on-site personnel.

Share responder information.

Coordinate resources that already exist at the emergency location.

That moves the ECC from being merely a communications destination toward becoming an orchestration point for the emergency response.

The telecommunicator does not have to physically touch the AED.

They need to make sure the right person can.

That is a subtle distinction.

But technologically, it is an enormous one.

John, Erika… Look What You Started

And that brings me back to where this began. A conversation between colleagues.

John looked at the chain of survival and reminded us how important the 911 professional is within it.

Erika helped bring the accessibility problem into focus.

I looked at the same problem through my technology lens and wondered why we couldn’t connect those pieces.

None of those perspectives replaces the others.

They strengthen each other.

That is something I have learned repeatedly through years of working with people across public safety. Operations sees things technology misses. Technology sees possibilities operations may not know exist. Standards people ask whether everybody can make it work together. Policy people ask who is allowed to do it.

Most Important are the folks sitting at the console, who tell us whether our brilliant idea is actually usable at 2:00 in the morning during a real emergency.

That is how good public-safety innovation happens.

Not because one person magically sees the entire answer.

But because different people bring different pieces of the problem under the same umbrella and keep asking questions until the edges begin to connect.

The Bottom Line

I am not proposing a finished product here.

I am not proposing a standard.

And I am certainly not suggesting that every public-access AED suddenly needs an electronic lock.

In fact, where an AED can remain completely open and immediately accessible, the evidence says we should avoid putting unnecessary barriers in front of it.

What I am suggesting is that when security concerns become the reason an AED is not truly publicly accessible, we should stop accepting the assumption that our only choices are:

Protect the AED.

Or make the AED available.

Modern technology should allow us to do better than that.

If 911 already knows there is a cardiac arrest…

if 911 knows where the AED is…

if 911 is already directing someone to retrieve it…

then why can’t 911 open the door?

That seems like a question worth answering.

Because an AED sitting 150 feet away from a cardiac-arrest patient should not become useless over the last twelve inches.

Especially when the only thing standing between the rescuer and the device…

is a lock we already know how to open.

Sources and Background

• John Chiaramonte LinkedIn post on sudden cardiac arrest and the 911 professional as the first link in the chain of survival
• ILCOR scoping review: AED accessibility – benefits and harms of locked AED cabinets
• Knox eLock system – example of electronically managed emergency access with audit history
• Peer-reviewed discussion of public AED accessibility and cabinet-related delay