How NH towns are trying to make life-saving AEDs more accessible in public outdoor spaces
The Swanzey town ball fields have six baseball diamonds, a pavilion and a play structure with slides.
The park’s newest feature is in a bright-red box attached to a cinderblock wall. It’s one that Deputy Fire Chief Brandon West hopes will see little use.
Last month, the Swanzey Fire Department installed automated external defibrillators at the ball fields, another park and a town beach. The devices, known as AEDs, deliver a shock that can revive someone experiencing cardiac arrest. Bystanders can use them before first responders get to the scene.
If someone’s heart suddenly stops beating, West said the devices could make all the difference. Not that he’s looking for a chance to try them out.
“In a way, I hope they're never used,” he said.
New Hampshire has thousands of sites with fixed AED boxes, but the vast majority are inside buildings. Now, first responders in some towns have started to put the devices in outdoor locations as well, making them accessible 24/7 in a wider range of public spaces.
“It seems to be something that's a fairly new concept,” Mark Doyle, the director of the state’s Division of Emergency Services and Communications, said of permanently installing AEDs in outdoor settings.
When the heart’s electrical system stops working, causing it to no longer pump blood, an AED can detect the irregular rhythm and shock it back into beating normally. But it has to happen fast. The FDA says a person’s chances of survival during cardiac arrest decrease 7 to 10 percent each minute.
AEDs are intended for use by the general public, one reason the American Heart Association recommends they be widely available in public settings. The Sudden Cardiac Arrest Foundation says the chances of survival go up about 25 percent when bystanders use AEDs before emergency services respond.
“Minutes do matter,” said Chief David Tauber of Linwood Ambulance Service.
Lincoln and Woodstock, the two towns the nonprofit ambulance service covers, have more than 60 AEDs between them. But many of them have been in hard-to-reach spots, like behind desks in commercial spaces, and not available outside business hours.
Tauber said his agency has tried to make those devices more accessible and visible. And this year, with help from the local rotary club, the ambulance service has a grant to place outdoor AED boxes in various spots.
He expects to install six to eight in the next few months, at locations like the school athletic fields, the North Woodstock town green, a local ski area and outside the Lincoln town hall.
Another is planned for the exterior of the Linwood Ambulance Service building. Though it’s not staffed 24/7, Tauber said, people sometimes come knocking on the door anyway.
“Minutes do matter."Chief David Tauber, Linwood Ambulance Service
While Tauber recommends CPR and AED training for everyone, training isn’t required. He said they’re relatively simple for most people to use.
“Nowadays they're completely computerized,” he said. “They talk to you. They tell you what to do step by step.”
Swanzey and the Lincoln-Woodstock area aren’t the only places expanding AED access in this way. Salem is considering one along its rail trail. And the Atkinson Police Department installed an emergency call box with an AED at a popular recreation area, Woodlock Park, in 2020.
Atkinson Police Chief Timothy Crowley said his priority was giving people a way to reach police dispatch immediately in the case of trouble, but the department opted for a model that came with an AED compartment. It made sense because of how much activity the park’s walking trails and ball fields see — including a vibrant pickleball scene with many seniors.
“They’re shoveling off the courts in the winter,” Crowley said. “They're very dedicated to their sport.”
Deploying AEDs outdoors presents a few technical challenges.
Tauber said the devices run about $1,000, so it’s a risk to leave them unsecured. The boxes he’s installing require a code to open. Ideally, bystanders would be able to get that from 911, but he said the state’s emergency-dispatch system can’t accommodate that right now.
Doyle, of the state’s emergency services division, said his agency is looking into that possibility. But for now, there will be a seven-digit police dispatch number on the outside of the boxes.
Swanzey’s system works a bit differently. When someone opens the box to grab the AED, 911 is notified automatically and video surveillance turns on. There’s also a button that calls 911. Doyle said the state is crafting new policies for handling those situations, as dispatchers may not be able to ask callers directly about their emergency.
“We don't want to run and jump to the assumption that just because an AED box was opened, that it's always going to be a medical emergency,” he said.
West said the Swanzey Fire Department is working with the state to iron out some of those details. Meanwhile, he hopes more communities consider placing AEDs in parks and other settings. He sees them as the crucial first link in a chain of responses.
“Hopefully, for that individual that ends up in that situation, they got their best chance that we get to save a life,” he said.