Unmanned aerial vehicles (drones) in out-of-hospital-cardiac-arrest.

A Claesson,Y Ban,J Lennartsson,L Svensson,M Rosenqvist,M Ringh,S Österberg,T Djarv,J Hollenberg,D Fredman,P Nordberg

doi:10.1186/s13049-016-0313-5

Abstract

BackgroundThe use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Drones or unmanned aerial vehicles (UAV) can fly with high velocity and potentially transport devices such as AEDs to the site of OHCAs. The aim of this explorative study was to investigate the feasibility of a drone system in decreasing response time and delivering an AED.MethodsData of Global Positioning System (GPS) coordinates from historical OHCA in Stockholm County was used in a model using a Geographic Information System (GIS) to find suitable placements and visualize response times for the use of an AED equipped drone. Two different geographical models, urban and rural, were calculated using a multi-criteria evaluation (MCE) model. Test-flights with an AED were performed on these locations in rural areas.ResultsIn total, based on 3,165 retrospective OHCAs in Stockholm County between 2006–2013, twenty locations were identified for the potential placement of a drone.In a GIS-simulated model of urban OHCA, the drone arrived before EMS in 32 % of cases, and the mean amount of time saved was 1.5 min. In rural OHCA the drone arrived before EMS in 93 % of cases with a mean amount of time saved of 19 min. In these rural locations during (n = 13) test flights, latch-release of the AED from low altitude (3–4 m) or landing the drone on flat ground were the safest ways to deliver an AED to the bystander and were superior to parachute release.DiscussionThe difference in response time for EMS between urban and rural areas is substantial, as is the possible amount of time saved using this UAV-system. However, yet another technical device needs to fit into the chain of survival. We know nothing of how productive or even counterproductive this system might be in clinical reality.ConclusionsTo use drones in rural areas to deliver an AED in OHCA may be safe and feasible. Suitable placement of drone systems can be designed by using GIS models. The use of an AED equipped drone may have the potential to reduce time to defibrillation in OHCA.

Highlights

The use of an automated external defibrillator (AED) prior to Emergency medical services (EMS) arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly
To use drones in rural areas to deliver an AED in OHCA may be safe and feasible
Finding the best suitable placement of unmanned aerial vehicles (UAV) A total of n = 7,256 OHCA cases were reported in Stockholm county between 2006–2013

Summary

Introduction

The use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Emergency medical services (EMS) in Sweden report approximately 5,000 cases of OHCA each year to the Swedish registry for cardio-pulmonary resuscitation (SRCR) in which cardio-pulmonary resuscitation (CPR). Dual dispatch using fire departments or police has been shown to shorten the response time and increase survival; the effect on 30-day survival is most significant in urban or downtown areas as compared to rural. A novel way of decreasing the delay from collapse to first shock in areas with long EMS response time could be to use a drone equipped with an AED. Simulation studies have found that the use of drones in emergency settings is most efficient and effective when flown on auto-pilot as compared to manual navigation [7]. Limitations in wind, flight endurance, payload and regulations need to be ensured for safe drone usage [8]

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