Why Aren't AEDs as Common as Fire Extinguishers?

When someone suffers a sudden cardiac arrest, every second matters. So why are the devices that can save their life still so difficult to find?

Take a moment to look around the next time you're in a shopping mall, office building, train station, school or sports complex. You'll probably spot a fire extinguisher within a few minutes. You may even notice the nearest emergency exit.

Now ask yourself another question.

Where is the nearest Automated External Defibrillator (AED)?

Chances are, you don't know.

And that's a problem.

Because if someone suddenly collapses from sudden cardiac arrest, knowing where the nearest AED is, and having the confidence to use it, could mean the difference between life and death.

Cardiac Arrest Doesn't Wait

Sudden cardiac arrest is one of the leading causes of death worldwide. Unlike a heart attack, which occurs when blood flow to the heart is blocked, cardiac arrest happens when the heart suddenly stops beating effectively because of an electrical malfunction. Without immediate intervention, survival becomes a race against time.

Every minute without CPR and defibrillation significantly reduces a person's chance of survival. After eight to ten minutes without intervention, survival becomes increasingly unlikely. In Malaysia, reported survival rates for out-of-hospital cardiac arrest remain low, estimated at between 0.5% and 8.5%. 

The reality is that most cardiac arrests don't happen inside hospitals.

They happen at home, in shopping malls, at train stations, in offices, on sports fields and in schools.

The first person who responds is rarely a doctor. More often, it's a family member, colleague, teacher, security guard or complete stranger.

More Than a Machine

Many people assume AEDs are complicated medical devices that should only be used by healthcare professionals. They aren't.

AEDs are designed specifically for members of the public. They provide clear voice instructions, analyse the heart's rhythm automatically and will only deliver a shock if it is needed. In other words, the device cannot shock someone unless it detects a rhythm that requires defibrillation.

The biggest barrier isn't the technology. It's awareness. People often don't know where an AED is located, or they lack the confidence to use one when faced with an emergency.

The Hidden Gap. We Don't Even Know How Many AEDs We Have

Here's a surprising fact.

No one can say with certainty how many publicly accessible AEDs Malaysia has.

Unlike countries with comprehensive public AED registries, Malaysia does not currently have a nationally accessible database that records where public AEDs are located. Hospitals, universities, airports, shopping malls, banks, corporate offices and community organisations have installed AEDs over the years, but these efforts have largely happened independently. At first glance, this may seem like an administrative issue.

In reality, it's a patient safety issue.

During a cardiac emergency, every minute matters. If bystanders or even emergency responders don't know where the nearest AED is, precious time may be spent searching for a device that could save a life. Knowing where an AED is can be just as important as having one.

What Can We Learn From Other Countries?

Several countries have shown that improving survival isn't simply about installing more AEDs. It's about making them visible, connected and easy to find.

In Singapore, publicly accessible AEDs are integrated into the myResponder mobile application, allowing nearby community responders to locate the closest device and respond quickly during an emergency (Singapore Civil Defence Force, 2025).

Japan has one of the world's most extensive public-access AED programmes, with devices commonly found in schools, train stations, airports and other public buildings. Public education on CPR and AED use has also become part of broader community preparedness (Japan Circulation Society, 2023).

In the Netherlands, citizen responder networks are linked with AED locations, enabling trained volunteers to retrieve nearby devices while emergency medical services are on the way (HartslagNu, 2024).

These countries don't just install AEDs. They make sure people know where they are.

Encouraging Signs in Malaysia

Malaysia is making encouraging progress.

Malaysia Airports has expanded AED availability across KLIA and KLIA2, while universities, corporate organisations, banks and hospitals continue to increase access within their own facilities.

Community organisations such as the Malaysian Red Crescent and St John Ambulance Malaysia continue to train members of the public in CPR and AED use, helping build a community that is better prepared to respond.

More recently, Sunway Medical Centre Velocity (SMCV) launched a community emergency preparedness initiative aimed at improving both access to AEDs and public confidence in using them.

The programme includes installing AEDs at MRT stations including Tun Razak Exchange (TRX), Bukit Bintang, Ampang Park and Muzium Negara, as well as Aquaria KLCC, office buildings and additional public spaces across Kuala Lumpur. It also includes CPR and AED training sessions, emergency awareness talks and QR codes linking members of the public to life-saving guidance.

The initiative demonstrates an important principle. Installing AEDs is only one part of improving survival. Equipping people with the confidence and knowledge to act is equally important.

Every Community Should Be Ready

Imagine if every school, office, apartment building, shopping mall, sports complex and community hall had a clearly marked AED.

Imagine if learning CPR became as common as participating in a fire drill. Imagine if every Malaysian knew exactly where the nearest AED was. These aren't unrealistic goals. They're practical, achievable measures that could save countless lives.

Would you know where the nearest AED is in any of these places?

If the Answer Is "No"... You're probably not alone.

Many Malaysians have never seen an AED, don't know where one is located, or worry they might do the wrong thing in an emergency. That's why increasing awareness is just as important as installing more devices.

What You Can Do Today

You don't have to be a healthcare professional to help save a life. You can:

• Learn CPR through a certified training provider.

• Find out whether your workplace, school or apartment has an AED.

• Ask your employer or building management where it is located.

• Encourage your organisation to install an AED if one isn't already available.

• Learn to recognise the signs of sudden cardiac arrest.

• Share what you've learned with your family, friends and colleagues.

Sometimes, the most powerful form of advocacy begins with asking one simple question.

"If someone collapsed here today, would we know what to do?"

If every building is expected to have a fire extinguisher, perhaps it's time we asked a new question. Should every major public building also have an AED?

At Vital Signs Asia, we believe improving survival from sudden cardiac arrest requires more than excellent emergency medicine. It requires communities that are prepared, informed and equipped to act. That means:

• More publicly accessible AEDs across Malaysia.

• A comprehensive national registry or map so anyone can quickly locate the nearest AED.

• Wider CPR and AED training for the public.

• Clearer signage in workplaces, schools, shopping centres and public spaces.

• Stronger collaboration between healthcare providers, businesses, educators and government.

Because when cardiac arrest happens, the first responder is rarely a doctor.

It's usually one of us.