The abundance of automated defibrillators in Japan

The first time I saw an Automated External Defibrillator, AED for short, was in Japan. An AED is a machine designed to help people who are suffering from a heart attack. While waiting for an ambulance, bystanders can fetch the machine, connect the electrodes to the patient and the machine will automatically determine if it is necessary to administer an electric shock. It is important to note though, that CPR (resuscitation) remains vital. AEDs are designed to be used together with CPR.

philips heartstart AED
The Philips Heartstart AED
philips heartstart AED placement of electrodes
Electrodes are placed on the patient and the machine determines if an electric shock should be administered

While we have AEDs in Belgium as well, they seem to be few and well hidden. In Japan on the other hand, AEDs are everywhere. And there are clear signs indicating where the AEDs are. Have a look at this map, giving an overview of all AEDs in Atsuta Jingu park in Nagoya:

a map of all available AEDs in Atsuta jingu in Nagoya, Japan
A map of all available AEDs in Atsuta shrine in Nagoya, Japan. The hearts indicate the location of the AEDs. I count four AEDs in this park alone. Amazing!
AED in Japan
A clearly visible AED near the entrance of the toilets in a shopping centre in Japan. There is a flashlight on top of it. I wonder how it is activated. Are there buttons throughout the shopping centre that activate the flashlight and thus guide you to the AED?

One might argue that this abundance of AEDs is due to Japan’s ageing population. Belgium however also has an ageing population, yet AEDs are not omnipresent. Personally, I attribute the availability of AEDs in Japan to Japan’s concern with safety (安全 anzen). The lengths that Japanese people and authorities go through to ensure safety in all possible situation is impressive. Japan is covered with signs warning you about all possible dangers. ‘Anzen’ (safety) is a word that I quickly learned while living in Japan!

What do you think about AEDs in Japan? Do you also find there are so many of them? Why do you think that is?


7 thoughts on “The abundance of automated defibrillators in Japan

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  1. this is interesting. never thought much about it before. now that i have read your post, makes me think about where i could get/find one where i live, as this is certainly not something that is easy to find.

    1. Yes, I agree. I looked it up for where I live, and the city website lists only two machines. But when I took a CPR course, the participants seemed aware of many more machines. Those machines where not acquired by the city but by private instances, like for example a supermarket. What a shame that there is no complete overview on the city website.

      What they did tell me in the course is that you should always give priority to performing CPR over finding an AED. If possible, send someone else to get an AED. But if you are alone, just stick to CPR after calling an ambulance and forget about the AED.

      1. yeah. i would agree with that. most people are not properly trained in this sort of situations. even for those who have learned CPR, they might not be able to do it right due to the very few opportunities to practice it.

  2. A fireman I know here told me that they started installing AEDs everywhere after Prince Takamado (the emperor’s cousin) suddenly died of heart failure in 2002. He was only 47, and if there had been an AED available right away, they might have been able to save him. I’m not sure how direct the correlation is, but it seems that was a big impetus.

    I have used practice AEDs once in a disaster preparation course I was interpreting for. The instructions are all in Japanese, but there are clear vocal instructions for how to work the machine, so theoretically they should be easy to use in a panic. However, even with practice machines, a lot of the Japanese people were confused and had trouble following simple instructions like “Move away from the patient. Do not touch the patient. Administering shock now.” I hope that those practice sessions help them get the kinks out before they need to a use a real one…

    1. Very interesting to hear about Prince Takamado. Thanks for sharing this!

      I do think people can be intimidated at the thought of intervening in an actual emergency. Perhaps Japanese people even more so than Western people? But a Belgian fireman friend of mine said: “Don’t worry about doing something wrong. If you do nothing, the person will die, so you can’t make it worse. Just do your best.” がんばりましょうね。

  3. There have been news stories about runners in marathons having been saved by AED and though I cannot remember specifically in what sort of situation, I have read other news stories about people’s being saved by the kit.

    It’s great that it’s available in many places but it’s really whether or not there may be people around you that may be able to or willing to help using it when you need it that probably matters.

    I have personally never touched it (or have ever performed a CPR for that matter.) I hope I won’t panic when it comes to that.

    1. Yes I agree. I think that probably CPR remains the most important thing, of course together with someone willing to take charge if something like that happens.

      Seeing all the AEDs in Japan made me aware of these things and back in Belgium I followed a short CPR course. So hopefully I will know what to do if something like that ever happens.

      In my psychology studies, I learned about something called ‘the bystander effect’. There is a direct negative correlation between the number of bystanders in an emergency and the likelihood of help being offered. So the more people there are when something happens, the less likely it is that someone will help. Strange, isn’t it? But maybe knowing this, I may be able to overcome this effect if I am such a situation myself someday. It also helps if you give orders to the people standing around doing nothing. Research shows that when given an order, people do start helping.

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