By the U.S. Fire Administration
Can medical drones reduce the time to cardiac treatment by getting an automated external defibrillator (AED) into the hands of a bystander?
Preliminary studies suggest that drones may make a life-saving difference in providing emergency care to cardiac arrest patients, especially those in a rural setting.
The American Heart Association estimates that more than 350,000 out-of-hospital cardiac arrests (OHCAs) occur in the United States every year.
Seventy percent of these occur in homes.
While multiple studies have shown that AEDs can significantly increase chances of survival, a critical factor is the amount of time that elapses from victim discovery to treatment.
(Drone tests by Swedish researchers to deliver AEDs to those suffering cardiac arrest. Learn More below. Courtesy of TomoNews and YouTube)
What are the Potential Benefits of Drone-Delivered AEDs?
- Prototype medical drones may fly up to 100 kph (62 mph). They can possibly fly directly to a victim’s location using a bystander’s cell phone GPS as a target.
- Most communities don’t have systems in place to deploy static, public-access AEDs to the scene of an emergency. Drone-delivered AEDs can fill this gap and respond as part of an active and integrated 911 response.
- Drones can reach home or private location cardiac arrests where public static AEDs are almost never used. They fly over the traffic and are able to travel in straight lines.
- Drones could be available 24/7, which often is not the case with static AEDs.
- Drones can deliver AEDs to balconies or upper levels in high-rise buildings, thus potentially reducing “access time” to treatment that might otherwise be minutes longer for responding EMS.
- A 911 dispatcher can use a drone’s camera to visually assess a victim and support bystander CPR and AED application.
Drone-delivered AEDs have the potential to be a transformative innovation in the provision of emergency care to cardiac arrest patients, especially those who arrest in a private or rural setting.
— Pulver, Wei, Mann, 2016
What Does the Research Show?
Research into the practical use of medical drones for the delivery of AEDs is still in its very early stages and much work and testing remains, along with the development of appropriate regulatory guidelines.
However, a Canadian study shows that survival rates decline by 23 percent for every minute that passes between the onset of cardiac arrest and the start of defibrillation.
Pre-placement of static AEDs to public buildings or venues is not extensive enough and rarely helps those in homes where the majority of OHCAs occur.
Two recent studies, one from Salt Lake City in 2016 and another from the Toronto metro region in 2017, used mathematical models to look at how a systematic, geographical placement of medical drones equipped with AEDs might reduce the time to cardiac treatment by getting an AED much more quickly into the hands of a bystander.
While the Salt Lake City and Toronto models differ in important respects, they both theoretically show that medical drones equipped with AEDs can be deployed from optimally located launch sites across a large metro area to ensure a much faster travel time than via traditional ground transport.
(Each year nearly a million people in Europe suffer from a cardiac arrest. A mere 8% survives due to slow response times of emergency services. The ambulance-drone is capable of saving lives with an integrated defibrillator. This new type of drone can go over 100 km/h and reaches its destination within 1 minute, which increases chance of survival from 8% to 80%! This drone folds up and becomes a toolbox for all kind of emergency supplies. Future implementations will also serve other use cases such as drowning, diabetes, respiratory issues and traumas. Corrective Statement to the video: One should never leave the patient alone and always start performing CPR first. Please send out a bystander to retrieve an AED or Ambulance Drone in case of Cardiac Arrest. Courtesy of TU Delft and YouTube)
Has Anyone Tested Drone Delivery of AEDs in the Field?
A preliminary study out of Sweden was published in June, 2017. Swedish researchers operated an eight-rotor drone from a fire station in a suburb of Stockholm to deliver an AED to locations where OHCAs had occurred between 2006 and 2014.
Over a 72-hour period they conducted 18 remotely operated, beyond line-of-sight flights.
The drone-delivered AED arrived in every case faster than EMS, with a median reduction in response time of more than 16 minutes.
The Peel region of Ontario may see testing of the delivery of AEDs to remote locations as early as next year.
- Selecting drone launch sites means making choices. Do you locate and resource enough drones to cover an entire region equally? Or do you weigh costs and look to deploy drones where the need is measurably highest?
- How time-consuming and costly will drone maintenance be?
- How will recharge time or swap-out of AEDs factor into a medical drone system deployment?
- How long should the drone remain on scene? Does the drone return to base only after 911 arrives?
- In the United States, drones will first need permission to fly beyond operator line-of-sight. Drones will need to prove they can safely navigate around no-fly zones such as airports and avoid high-rise buildings and other obstacles.
- Will drones be able to operate in poor weather such as icing, turbulence and extreme cold?
- How will they perform over distances longer than in the Swedish study (about 2 miles)?
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Boutilier, J., Brooks, S., Janmohamed, A., Byers, A., Buick, J. et al. (2017). Optimizing a drone network to deliver automated external defibrillators. Circulation: Vol 136 (20) https://doi.org/10.1161/CIRCULATIONAHA.116.026318
Claesson, A., Bäckman, A., Ringh, M. et al (2017). Time to delivery of an automated external defibrillator using a drone for simulated out-of-hospital cardiac arrests vs emergency medical services. Journal of the American Medical Association: Vol 317 (22) doi:10.1001/jama.2017.3957
Pulver, A., Wei, R., Mann, N. (2016). Locating AED enabled medical drones to enhance cardiac arrest response times. Prehospital Emergency Care: Vol 20 (3) http://dx.doi.org/10.3109/10903127.2015.1115932