Abstract
BackgroundEarly defibrillation is essential for increasing the chance of survival in out-of-hospital-cardiac-arrest (OHCA). Automated external defibrillator (AED)-equipped drones have a substantial potential to shorten times to defibrillation in OHCA patients. However, optimal locations for drone deployment are unknown. Our aims were to find areas of high incidence of OHCA on a national level for placement of AED-drones, and to quantify the number of drones needed to reach 50, 80, 90 and 100% of the target population within eight minutes. MethodsThis is a retrospective observational study of OHCAs reported to the Swedish Registry for Cardiopulmonary Resuscitation between 2010–2018. Spatial analyses of optimal drone placement were performed using geographical information system (GIS)-analyses covering high-incidence areas (>100 OHCAs in 2010–2018) and response times. Results39,246 OHCAs were included. To reach all OHCAs in high-incidence areas with AEDs delivered by drone or ambulance within eight minutes, 61 drone systems would be needed, resulting in overall OHCA coverage of 58.2%, and median timesaving of 05:01 (min:sec) [IQR 03:22–06:19]. To reach 50% of the historically reported OHCAs in <8 min, 21 drone systems would be needed; for 80%, 366; for 90%, 784, and for 100%, 2408. ConclusionsAt a national level, GIS-analyses can identify high incidence areas of OHCA and serve as tools to quantify the need of AED-equipped drones. Use of only a small number of drone systems can increase national coverage of OHCA substantially. Prospective real-life studies are needed to evaluate theoretically optimized suggestions for drone placement.
Highlights
In Europe the incidence rate of out-of-hospital-cardiac-arrest (OHCA) is approximately 38À55 per 100,000 population,[1] equivalent to around 275,000 cases every year
Between 2010À2018 a total of 44,977 OHCAs was reported to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR)
High-incidence areas with timesaving potential In Optimal areas A, we identified a total of 22 areas for drone deployment, giving an additional 20.4% coverage (Fig. 3b and Table 2), and representing 52.9% of OHCA cases in Sweden reached with an Automated external defibrillator (AED) from either ambulance or drone within eight minutes
Summary
In Europe the incidence rate of out-of-hospital-cardiac-arrest (OHCA) is approximately 38À55 per 100,000 population,[1] equivalent to around 275,000 cases every year. Every year the Swedish EMS report bystander initiation of CPR to the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) in about 6000 cases of OHCA.[5] The time delay to ambulance arrival has increased over the years, reaching a median delay of 11 min in 2019.5 Despite widespread basic-life-support (BLS) training in the community[6,7] and efforts to implement public-access defibrillators alongside a national automated external defibrillator (AED). Our aims were to find areas of high incidence of OHCA on a national level for placement of AED-drones, and to quantify the number of drones needed to reach 50, 80, 90 and 100% of the target population within eight minutes.
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