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The use of the automatic external defibrillator (AED) can significantly reduce the time to defibrillation in patients with sudden cardiac death. This early defibrillation via the AED can also improve patient outcome, including survival and neurologic status among survivors. We undertook the addition of a public access defibrillation program at a large mid-Atlantic university. In our design of the system, we found little useful information to guide us in the development and construction our system. This article is a review of the process of public access defibrillation AED system development such that other medical and academic leaders at similar institutions can more easily develop such systems.