How Many AEDs Does a Building Need? The One-Per-Floor Rule for Multistory Sites
Most AED coverage advice is written for a floor plan ā how far across a space someone has to walk. In a multistory building that is the wrong axis. The constraint is vertical, and it behaves very differently from horizontal distance.
This article covers only that case: buildings with floors. If your problem is after-hours access, perimeter coverage or outdoor placement, our piece on time to first shock is the one you want, and it also contains the walk-it-and-time-it audit referenced below. For general coverage geometry on a single level, see where to place an AED.
Why stairs are not just more distance
Horizontal distance scales predictably. A responder crossing an open floor moves at a steady pace and can see where they are going. Vertical distance does not behave that way, for four reasons that compound:
- Stairs are slow, and slower carrying something. A person descending four flights with an AED under one arm and a handrail in the other is not moving at their normal walking pace, and they are moving slower still on the way back up.
- Elevators are a gamble, not a shortcut. Wait time is unpredictable and it is the one variable nobody accounts for when they picture the trip. Many responders will take the elevator down, find themselves waiting, and lose more time than the stairs would have cost.
- Stairwell doors are frequently one-way. Fire-code stairwells often re-enter only at designated floors, and badge readers on floor doors are common in multi-tenant buildings. A responder can end up in the lobby with the device and no fast route back.
- Floors hide the device. On one level, a responder can often see the cabinet or a projecting sign from across the room. From four floors up, they are relying on memory of a building they may not work in.
The result is that a lobby AED in a five-story building commonly produces a round trip in the three-to-five-minute range ā and the useful window for defibrillation sits well inside that.
A state agency worked this problem in public
Hawaii's Department of Accounting and General Services finished a statewide installation in August 2026 that is worth studying, because the agency published enough detail to see its reasoning.
DAGS installed 162 AEDs across roughly 40 multistory state buildings over seven months at a cost of $250,000, placing at least one unit on every floor. Distribution ran 120 units on Oahu, 21 on Hawaii Island, nine each on Maui and Kauai, and three on Molokai. Alongside the hardware, the program trained 920 state employees through the Hawaii Heart Foundation's Common Sense CPR program.
| Figure | What it tells you |
|---|---|
| 162 units / ~40 buildings | Roughly four floors per building, one device each |
| $250,000 total | About $1,500 per installed unit across mixed models and mounting conditions |
| 920 employees trained | Training budgeted in the same program as the equipment, not separately |
| 7 months | Realistic timeline for a multi-site rollout including training |
Two things matter more than the headline number. The placement rule was one per floor, not one per building ā and an agency buying at this scale had every budgetary incentive to choose otherwise. And the training figure sits inside the same program as the equipment figure. Most organizations split those into separate line items owned by separate departments, which is how a building ends up with excellent hardware and nobody confident enough to take it off the wall.
The agency also had its own precedent. DAGS Director and Acting Lieutenant Governor Keith Regan noted that after Hawaii deployed AEDs across its airports, sudden cardiac arrest survival at those facilities rose from zero to above 70 percent.
What one-per-floor actually means in practice
The rule is a starting point, not the whole specification. Three adjustments come up repeatedly:
- Put it by the stairwell or elevator lobby, not in a suite. The device should be on the circulation path every floor shares, reachable without entering a tenant space or an office that locks.
- Large floor plates need two. One-per-floor assumes a responder can cross the floor quickly. A full-block floor plate or a wing layout needs a device per wing, which is a horizontal problem stacked on top of the vertical one.
- High-risk floors get their own regardless. A fitness room, a cafeteria, a mechanical plant or a floor with an older resident or employee population justifies a device on proximity alone, whatever the building-wide count says.
For the reach, height and protrusion limits that decide where a cabinet can legally go in a corridor, see AED cabinet and mounting requirements. For the per-device cost over a decade rather than at purchase, our ten-year cost of ownership breakdown is the figure to put in a budget request.
The budget conversation
Going from one device to five in a five-story building is a real number, and "we should have more AEDs" will not carry it. What carries it is a floor-by-floor map with a measured round-trip time on each floor and a cost against each gap. Hawaii's $1,500-per-installed-unit figure is a defensible public benchmark to build that estimate on, and the fact that a state agency reached the same conclusion is useful cover for a facilities director making the case internally.
Worth pairing with the training line. Hawaii trained 920 people alongside 162 devices, and a request that funds both reads as a program rather than a purchase.
Frequently asked questions
How many AEDs does a multistory building need?
At minimum one per floor, positioned on the shared circulation path near the stairwell or elevator lobby. Large floor plates need one per wing, and high-occupancy or high-exertion spaces such as fitness rooms and cafeterias justify a device on proximity regardless of the building-wide count.
Why is one AED in the lobby not enough?
Because vertical distance costs more time than horizontal distance. Stairs are slow while carrying a device, elevator wait times are unpredictable, stairwell doors often do not re-enter on every floor, and a responder several floors away is working from memory of where the cabinet is. A lobby-only device in a five-story building commonly produces a three-to-five-minute round trip.
What does full multistory AED coverage cost?
Hawaii's 2026 state building program provides a public benchmark: 162 units installed across roughly 40 multistory buildings for $250,000, or about $1,500 per installed unit across mixed models and mounting conditions. Your figure will vary with model, cabinet type and installation conditions.
Where should the AED go on each floor?
On the circulation path the whole floor shares, typically the elevator lobby or beside the stairwell, and never inside a suite or an office that locks. It should be visible from both directions along the corridor, which usually means a projecting sign rather than a flat wall decal.
Send us a floor plan and we will mark the gaps
Tell us how many floors, roughly how big each one is, and where your devices are now. We will come back with the floors that are uncovered, where a unit should go on each, and what it costs to close. Useful whether or not you buy anything.
Shop AEDs ā | AED cabinets ā | Call 888-541-2337
Sources
- Hawaii News Now, "DAGS installs 162 new life-saving AEDs in government buildings statewide," August 29, 2026 ā hawaiinewsnow.com
Related
- Minute eleven: time to first shock, outdoor cabinets and after-hours access
- Where to place an AED: coverage & distance
- AED cabinet & mounting requirements
- How much does an AED cost: ten-year ownership
- AED requirements for businesses
Last reviewed: September 1, 2026. Cost figures are publicly reported benchmarks, not quotes. Retrieval times vary with building layout, door hardware and elevator performance ā measure your own.
