China Sounds Alarm on AED Reliability at Critical Moments

Chinese authorities and state media are raising urgent concerns about the reliability of Automated External Defibrillators (AEDs) in public spaces, warning that equipment failures, poor maintenance, and public hesitation are undermining a nationwide push to deploy the lifesaving devices. An investigative report published May 28 by Xinhua News reveals that many installed AEDs are inaccessible, locked away, or left with expired pads and dead batteries — a state the report calls “disability” — just when they are needed most.

The Scale of the Challenge

China records approximately 550,000 sudden cardiac deaths annually, the highest number of any country in the world. The “golden four minutes” following cardiac arrest are critical: survival rates approach 90% if defibrillation occurs within one minute and roughly 60% within four minutes. Yet gaps in China’s AED network mean those precious minutes are often wasted.

In 2021, China’s National Health Commission issued guidelines promoting AED coverage in subways, commercial areas, office buildings, and other densely populated spaces. Cities have responded — Beijing’s subway now has AEDs at all operational stations, Shanghai added over 8,000 devices in 2025 alone, and Shenzhen’s pioneering “Public Defibrillation Plan” has installed more than 43,000 devices, saving 198 lives as of March 2026. But the Xinhua investigation reveals a troubling gap between deployment and effective emergency response.

Three Barriers to Effective Rescue

The report identifies three persistent barriers: “can’t find, dare not use, and don’t know how.”

Can’t Find: Despite increased deployment, distribution remains uneven and information is siloed. Reporters found that locating an AED in a Guiyang shopping mall took seven full minutes. Some devices were locked in office corners; others had expired electrode pads or dead batteries. Even when devices are installed, signage is often unclear and location data outdated.

Dare Not Use: The psychological barrier may be even more widespread. Many people mistakenly believe that “only professionals can operate” AEDs or that “operating it wrong means taking responsibility.” This persists despite Article 184 of China’s Civil Code — the “Good Samaritan Clause” — which explicitly states that voluntary emergency rescuers are not civilly liable for damages caused to the recipient. As Beijing.gov.cn reported, Dr. Guo Wei, Vice President of Beijing Traditional Chinese Medicine Hospital, emphasized: “As long as you have the ability to actively rescue, even if the outcome is not good, you will not bear legal responsibility. Good people will be protected by the law.”

Don’t Know How: Public awareness that AEDs are designed for untrained users remains low. “They don’t know that AEDs are essentially ‘idiot-proof machines’ — once turned on, voice guidance leads you through every step, and even someone with zero training can operate them,” the Xinhua report notes.

Success Stories Show What’s Possible

When AEDs are accessible and people are trained, they save lives. Recent high-profile rescues demonstrate the potential:

• On May 7, 2026, Shanghai Metro Line 7 station manager Tan Weidong used an AED to revive a passenger who had collapsed with cardiac arrest.
• Shenzhen Metro employees, over 10,000 of whom hold first-aid certifications, have saved 72 people since 2019.
• Beijing subway staff have used AEDs successfully 85 times since 2020.

These cases, covered by CCTV and Beijing Daily, show that when the system works, it works remarkably well.

Innovative Solutions Emerge

Grassroots innovation is filling some gaps. In Tianjin, food delivery rider Wang Bowen carries an AED on his electric scooter, transforming into an urban “first-aid cavalry.” In Shanghai, private car owners place AED signs on rear windows noting “break window in emergency.” Ride-hailing drivers in Xi’an have used车载 AEDs to save passengers before ambulances arrived.

Experts are calling for a unified national AED information platform connected to 120 dispatch systems and navigation apps, enabling citizens to locate and access the nearest device instantly.

What’s Next

The Xinhua investigation signals growing official attention to the gap between deployment and effective usage. Analysts expect new regulatory measures on maintenance standards, public training requirements, and integrated digital platforms. With tens of thousands of AEDs still needed to reach developed-country per-capita levels, China also represents a massive growth market for medical device manufacturers.

But the ultimate challenge may be cultural. As the report concludes, the hardware gap is gradually being filled — the real work lies in filling the “last mile” of public awareness and transforming bystander hesitation into confident action.