Abstract 9873: Comparing Base Locations for Drone-Delivered Defibrillators

Abstract

Introduction: Drone-delivered defibrillators may improve response for out-of-hospital cardiac arrest (OHCA). Prior studies have assumed that drones may be stationed at any police, fire, or paramedic station; however, cross-service implementation may not be logistically feasible. We sought to compare estimated response times by drone base location type. Methods: We included OHCAs (Jan. 2014 to Dec. 2020) in southern Vancouver Island, British Columbia, Canada where OHCA response includes fire and paramedic services. We created four models with candidate drone base locations at: police stations, fire stations, paramedic stations, and on a grid with 1 km sides as an optimistic model. We used mathematical optimization to select 1-5 drone bases for each model. Assuming a drone system had been in place during the study period and accounting for drone availability, we estimated 9-1-1 call-to-defibrillator intervals (measured to either drone, paramedic, or fire arrival) and calculated the proportion of OHCAs where a drone would arrive prior to fire and paramedic for each model. Median response times were compared to historical response using one-sided sign tests. Results: We included 1,610 OHCAs with a median historical response time of 6.4 mins (IQR 5.0-8.6). We identified 21 police stations, 59 fire stations, 21 paramedic stations, and 7,008 grid locations in the study area. Median 9-1-1 call-to-defibrillator intervals ranged from 4.3-5.3 mins for police, 4.3-5.3 mins for fire, 4.5-5.4 mins for paramedic, and 4.2-5.4 mins for grid locations (all P<0.001). Drones arrived prior to fire and paramedics in 36.6-65.4% of cases for police, 38.1-66.2% for fire, 37.3-63.2% for paramedic, and 35.7-66.8% for grid locations. Conclusion: Locating drone bases at different types of emergency service stations significantly decreases 9-1-1 call-to-defibrillator intervals, while resulting in similar response intervals to those achieved using optimistic grid-optimal locations.