Cafes, ATMs might be good places for emergency defibrillators

(Reuters Health) - Storing defibrillators at coffee shops and banks with automated teller (ATM) machines might help bystanders provide faster emergency aid to patients having a cardiac arrest, a Canadian study suggests.

That’s because these places are often located near where patients typically experience cardiac arrest, and they may be open around the clock, researchers conclude in the journal Circulation.

Plus, bystanders who have no idea where to look for what’s known as an automated external defibrillator (AED) can probably easily find the nearest bank or chain coffee shop like Tim Hortons or Starbucks.

“They generally have good geographic coverage, are typically located in high-traffic areas, and have strong brand recognition,” said senior study author Timothy Chan, director of the Center for Healthcare Engineering at the University of Toronto.

“If you ask someone on the street where the closest AED is, they probably wouldn’t know,” Chan said by email. “But I’m pretty sure they could point out the closest coffee shop or ATM because they go there regularly.”

In cardiac arrest, the heart stops abruptly, often due to irregular heart rhythms. Cardiac arrest may occur with no warning and is often fatal unless the heart can be restarted quickly.

Automated defibrillators are already in public places like restaurants and airports. These devices typically have electrodes that attach to the chest with sticky pads and deliver shocks based on what a computer in the defibrillator determines the person needs.

Even though these devices are already in the community, researchers wanted to see if they might place defibrillators in different locations to make them easier to find and more quickly available to patients in need.

For the study, Chan and colleagues examined data on the location of 2,654 cardiac arrests that happened in various community locations around Toronto from 2007 to 2015.

Then, they mapped out locations of 41 types of businesses to see how many establishments were situated within 100 meters (328.08 ft) of a cardiac arrest and what hours these places were open.

Over the entire Toronto region studied, the greatest number of cardiac arrests happened near Tim Hortons, a fast food restaurant chain known for its coffee and donuts. During the study period, there were 286 cardiac arrests within 100 meters of a Tim Hortons.

For downtown Toronto, Starbucks ranked first, with 110 cardiac arrests occurring nearby one of these coffee shops. All but two of the top 10 most common spots near a cardiac arrest in the downtown area were either a coffee shop or an ATM machine from one of the largest Canadian banks.

One limitation of the study is it focused on businesses that may be specific to Toronto and not exist in other cities, the authors note. The majority of cardiac arrests occur in a hospital, not in the community, so defibrillator locations at places like banks or coffee shops would not impact the majority of patients, researchers also point out.

Even when defibrillators are available in the community, it can still be crucial for a bystander to perform cardiopulmonary resuscitation (CPR), said Dr. Richard Page, a public health researcher at the University of Wisconsin in Madison.

“The first step in any cardiac arrest is to employ CPR, and now, with hands-only techniques, this procedure is so simple that it can be taught over the phone by the 911 operator,” Page, coauthor of an accompanying editorial, said by email.

Defibrillators with clear instructions may not be that hard to use once people find them, but there’s a potential to delay lifesaving care while bystanders search for one.

“The likelihood of survival from cardiac arrest diminishes up to 10 percent for every minute where AED placement is delayed, so response must be immediate,” Page said.

“I am a strong advocate for placement of AEDs throughout public locations, just as we have fire extinguishers,” Page said. “That being said, this paper focused on specific, common sites that are spread throughout a municipal area and might allow greater impact on sudden cardiac arrest in proportion to the number of defibrillators employed and the costs undertaken.”

SOURCE: and Circulation, online March 20, 2017.