When someone has a sudden cardiac arrest, every minute counts. The American Heart Institute guidelines say that for every minute, the chances of a victim surviving decrease by 7 to 10 percent. To help save lives, Automated External Defibrillators (AEDs) have become more and more ubiquitous, and now can be found in many different locations, including coffee shops, banks, malls, and sports complexes. When placing these devices though, a few issues need to be considered, including hours of operation, proximity of other AEDs, and being in high-traffic areas. To help inform these decisions, researchers from the University of Toronto recently conducted a very interesting study.
Using data on cardiac arrests that occurred outside of hospitals in Toronto from January 2007 to December 2015, they were able to place them on a map. They then identified businesses and municipal offices with at least 20 locations from sources such as the Yellow Pages, along with their hours of operation and geographic coordinates. For each site, they mapped the number of cardiac arrests that occurred within 100 m to identify which locations would be able to save the most lives. As a final test of these locations, they then looked at how the locations fared over time; determining if the locations relatively stable or if the AEDs have to be moved every year to continue to be effective.
Their analysis found that there were 2654 cardiac arrests in public spaces. Based on their analyses, they found that 286 occurred with 100m of a Tim Horton’s coffee shop (a major Canadian coffee chain for my international readers). Starbucks was the top in downtown Toronto, with their locations covering 110 cardiac arrests. In fact, of the top 10 locations to place AEDs, 8 were occupied by coffee shops and bank branches.
When minutes count, having people not have to search for an AED could potentially save lives. As the study author, Professor Timothy Chan, pointed out in this interview with the CBC:
“Most people probably don’t know where necessarily the closest AED is to them at any given point,” Chan said in an interview. “But you can probably have a rough idea where the closest Tim Horton’s is, or where your ATM is because you might frequent that ATM a lot.”
Creating a mental link between AED and these places you’re familiar with is “so powerful in helping activate people to respond,” he said.
Knowing how this can potentially save lives, the study authors suggest that organizations may consider this in their space planning process. An AED can cost between $1500-$2000, with an additional cost for training. While you may need a physician to help with the procurement process and act in a quality control capacity, this is a relatively small sum for a business to invest in a process that could potentially save customer lives, especially if they were to implement AEDs across all of their sites.
In another paper published two weeks prior, the authors explored another option for delivering AEDs – drones. Titled “Optimizing a Drone Network to Deliver Automated External Defibrillators,” this paper examined the size of the drone network needed to deliver AEDs faster than the historical 911 median response time. This found that a coordinated drone network could reduce times by between 6 and 10 minutes depending on whether the region was urban or rural. While one might think this technology is far into the future, drone technology is moving quickly and knowing the quantifiable benefits of such technology may even speed up adoption (see Amazon Air as an example). The intersection of engineering, emergency medicine, geospatial analysis, and epidemiology makes this and the previous study a fascinating proposal that has very tangible benefits for public health.
Next time you’re out, I encourage you to keep a look out for AED’s. They typically have signs up on the walls with the AED unit embedded in a small alcove, usually painted bright yellow or similar. Knowing where they are could save a life. Research like that discussed above though could take the guesswork out, and make it easier to find them if you are ever in a situation where one is needed.
Correction: This post originally mentioned a “heart attack” in the first paragraph, but should have referred to a “sudden cardiac arrest.” To quote the American Heart Association: “A heart attack is when blood flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops beating unexpectedly. A heart attack is a “circulation” problem and sudden cardiac arrest is an “electrical” problem.” Thanks to reader Kelsey for pointing that out!