Where Are We Now？
An Overview of Current Situation:
Emergency life-saving for SCA (sudden cardiac arrest) victims in the community
The current cumulative sales volume of AEDs (Automated External Defibrillators) in Japan is, as shown later, over 1.6 million (2023) .
However, their on-site usage rate is only about 4%, and approximately 80,000 lives are lost each year 220 people/day i.e. 1 person/7 minutes due to sudden cardiac arrest (SCA) in the community.
The average time it takes for an ambulance to arrive is about 9 – 10 minutes, and, as shown in the graph below, after cardiac arrest, the chances of survival drop by 7-10% for every minute.
Survival rate from cardiac arrest
Progression from SCA and lifesaving limits
Resuscitation must begin within 3-5 minutes of cardiac arrest, but
it takes about 9-10 minutes for an ambulance to arrive.
The time it takes for an emergency lifesaver to begin initial rescue measures after cardiac (cardiopulmonary) arrest is 12 minutes on average, including the time it takes to call the emergency services. In this case, the survival rate is less than 3%, meaning that only 3 out of 100 people can be saved. Furthermore, it is said that the brain can only survive without oxygen for 3 to 4 minutes, and even if a person’s life is saved, they would suffer severe brain damage.
Namely, when cardiac arrest occurs, blood flow to the brain stops and consciousness is lost within 10 to 15 seconds. Damage caused by impaired blood flow to the brain progresses rapidly over time.
The graph above shows the time that has elapsed from when cardiac arrest occurs until life-saving measures are administered, and the survival rate. If life-saving measures are administered within one minute of cardiac arrest, 95% of patients will survive. If administered within three minutes, 75% of patients will survive without brain sequelae. After five minutes, the survival rate drops to 25%, and after eight minutes the chances of survival become extremely low. You can see that starting the life-saving measures is a race against time.
Current Situation
Rapid implementation of life-saving measures is important for survival rates and social reintegration rates. No matter how many AEDs there are, the usage rate remains almost unchanged as mentioned above.
In addition, according to the survey results, half of the people who witnessed the collapse did not take any action to save the life of the victim and many lives that could have been saved are being lost.
Early CPR by ordinary citizens is crucial !
One-month survival rate and social reintegration rate for each time period from the time of witnessing to the time the ambulance staff started CPR (3-year total)
Comparing the one-month survival rate for each time period from when the victim was seen to when the lifesaving staff began CPR, the rate was 11.4% for 5 to 10 minutes, while it was 7.1% for 10 to 15 minutes, a rate that is approximately 0.6 times higher (-4.3 points). Furthermore, comparing the one-month social reintegration rate, the rate was 6.1% for 5 to 10 minutes, while it was 3.2% for 10 to 15 minutes, a rate that is approximately 0.5 times higher (-2.9 points).
Also, looking at the three-year trends, the one-month survival rate and social reintegration rate have increased in all time periods.
Annual trends in AED sales (cumulative)
The number of AEDs sold has been steadily increasing as mentioned above, however, the rate of AED use has been remaining almost unchanged.
Only 4.3% of SCA victims get an AED electric shock with no significant improved utilization in the past 20 years.
Japan AED Foundation AED Knowledge
Ministry of Internal Affairs and Communications (Fire and Disaster Management Agency): Current Status of Emergency and Rescue Services in 2023
According to the data shown above, the rate at which AEDs are used among people who experience acute cardiac arrest is 4.3%. And there has been no significant improvement in the past 20 years.
Furthermore, even among those who are witnessed collapsing in cardiac arrest, about half of them do not even receive CPR.
Where Do We Go From Here？
A Game Changer: “Pocket AED”
It is a portable size (200-300g) AED that anyone can carry and use easily.
We have developed and patented the circuit for the “Pocket AED” which can dramatically improve the spread and use of AEDs.
Comparison target: Current AED
Standard model: the size is W265ｍｍｘH100ｍｍｘD320mm and weighs approximately 2kg
Internal Structure of Current AEDs
Why current AEDs are large and heavy?:
It is mainly due to the internal structure (shown above) that is based on “C (capacitor)” and “T”. Importantly enough, this capacitor (C)–based electrical circuit restrictively allows just “single” electric shocks.
Current AED electric shocks are limited to single-shot waveform. The charged electricity is released in analog form, so the waveform cannot be controlled.
e.g.
Why “Pocket AED” would be a “Game Changer”?
(Ref. Estimation of Heath and Economic Benefits of a Small Automatic External Defibrillator for Rapid Treatment of Sudden Cardiac Arrest (SMART): A Cost-Effectiveness Analysis, Frontiers in Cardiovascular Medicine, 2022.)
If there are no AEDs nearby at the SCA victim rescue scene, there is no preparation for lifesaving measures. We planned first to further miniaturize the AED electric circuit by making it into a semiconductor chip for attaching integrated circuits. To date, we have developed the world’s smallest and lightweight portable AED device that is easy to carry anytime and can be used in everyday life.
Pocket AED (prototype)
Prototype of “Pocket AED”: the size is W160ｍｍｘH130ｍｍｘD80mm and weighs 200-300g (roughly the same as a smartphone)
The “pocked AED” uses a unique patented circuit that allows dramatic miniaturization. Notably enough, its implemented software can freely control the electric shot waveforms.
Pocket AED: A smartphone-sized AED for individuals to carry around.
Pocket AED weighs (200-300g) roughly the same as a smartphone. It can save lives even when traveling or outdoors where there are no other AEDs nearby.
Pocket AED is a portable AED that can immediately save a life “anytime, anywhere, and by anyone.”
In this context, it is not difficult to assume that there would be less sense of resistance for female SCA (sudden cardiac arrest) victims to have their breasts exposed by women than by men. Accordingly, it is also very important for weaker women that AEDs are easier to carry like our pocket AED. Likewise, making AEDs much smaller and lightweight is also quite important to spread life-saving training for elementary school children.
On-site Resuscitation Procedures (Pocket AED)
What’s more to the point?: DSED!
(DSED: double sequential external defibrillation)
It has already been demonstrated that AED double shock（DSED） dramatically increases the survival rate of SCA due to “refractory” ventricular fibrillation (VF). Pocket AED developed by Online Master’s patented technology enables, as a single AED device, the world’s first double shock delivery function (DSED). Accordingly, we are quite sure that the “pocket AED” would save much more refractory SCA victims.
First successful “double sequential external defibrillation” (DSED)
(Ref. Defibrillation Strategies for Refractory Ventricular Fibrillation,
New England Journal of Medicine, 2022.)
At the time of this first successful report, the only way to deliver consecutive shocks (DSED) at the emergency scene was to use a pair of fully charged AEDs.
Pocked AED: World’s first single AED equipped with DSED function.
Using the patented technology, we have succeeded in equipping the prototype pocket AED with the world’s first single device DSED (Double Pocket AED allows DSED simply by adjusting with the touch button. Namely, the time interval between the two consecutive electric shocks administered by “pocket AED” could be freely specified by the rescuer. This is the world’s first results from the pocket AED.
Waveform of the DSED (double sequential external defibrillation)
Patent acquisition status
| No. | Literature number | Application Number | Application date: | Public announcement date | Invention name | Applicant / Owner | Notes |
| １ | Patent 7493865 | Patent application 2023-579652 | 2023/08/25 | 2024/06/03 | Automated external defibrillator | Online Master | Overseas patent pending |
Online Master has completed the acquisition of the patent rights below. The following information is based on the public patent information database. (As of November 17, 2024)
Future development and spread of “pocket AED”:
Pocket AED is at the forefront of medical digital transformation (DX) for emergency resuscitation network building
