Sir, I write in response to the letter of P. Manek (AED value; BDJ 2011; 210: 501) on the value of AEDs in the practice setting. In the five-yearly CPD cycle, the GDC1 recommend at least ten hours of medical emergency training which serves to highlight the importance of managing medical emergencies within the dental setting.

Although this letter suggests only a very small chance of a cardiac arrest occurring in the dental surgery, the benefit of having an AED readily available leads to a certain 'peace of mind' for the dentist, the staff and patients alike should the unlikely occur. Indeed many patients feel reassured if an AED is on display as this indicates a practice that is well equipped and prepared. In addition it is an expectation of the public that AEDs are available in all healthcare environments.2

Whilst the quality and complexity of AEDs vary with price, machines are available from as little as £599 plus VAT with a seven-year warranty.

Consideration should also be given to the fact that most practices contain more than one dentist; it may be the relative, parent, a member of staff or a passerby who may arrest, which when taken into the equation alter the statistics significantly.

Add in the fear and anxiety exhibited by many patients combined with an element of pain and the odds of a cardiac arrest occurring increase further.

It is indeed correct that the majority of out of hospital cardiac arrests (OHCAs) are shockable but due to the lack of immediate ECG evidence the figures are not accurate. The Resuscitation Council3 suggests that the proportion of OHCAs is around 60% and each minute's delay before shock delivery results in a decreased successful outcome of 10-12%. The overall survival to hospital discharge from a VF/VT (ventricular fibrillation/pulseless ventricular tachycardia) arrest is 21.2%.3 With these statistics in mind and with consideration to ambulance arrival times varying, it would seem prudent to re-evaluate 'cost' implications of these life-saving machines.