Drones could speed up delivery of automated external defibrillators to patients suffering cardiac arrest

by European Society for Emergency Medicine (EUSEM)

edited by Sadie Harley, reviewed by Andrew Zinin

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Drones could be used to deliver automated external defibrillators (AEDs) to people experiencing out-of-hospital cardiac arrest, according to a study presented at the European Emergency Medicine Congress.

AEDs can be far apart, making timely access uneven, particularly in rural areas or heavily congested urban environments. The research showed that delivering AEDs by drone, combined with providing more fixed AEDs, significantly reduced the time between an out-of-hospital cardiac arrest (OHCA) being reported and the start of defibrillation.

"Out-of-hospital cardiac arrest is a major public health issue. Survival depends strongly on early cardiopulmonary resuscitation and timely defibrillation," Dr. Hillary Minka, an emergency physician at Lariboisière Hospital in Paris, told the congress. "Every minute of delay before defibrillation reduces the chances of survival.

"We wanted to investigate whether drones could provide faster AED access than road-based retrieval of existing fixed AEDs and thereby improve access to defibrillation across the Île-de-France region."

Minka and her colleagues used data on OHCAs in seven departments (administrative areas) in Île-de-France, excluding central Paris, to conduct a computer simulation study that looked at three strategies:

• Strengthening the current network of fixed AEDs
• Using drones to deliver AEDs
• Combining fixed AEDs with drones

They divided the region into units called Ilots Regroupés pour l'Information Statistique (IRIS), the smallest census areas used by the French National Institute of Statistics. They estimated the time needed for an AED to arrive at the center of each unit under each strategy. They also evaluated several potential locations for drone deployment, including existing AED sites, mobile intensive care units (MICUs) and fire stations.

They found that access to AEDs varied widely, with shortages in the countryside and on the outskirts of Paris. To improve access to fixed AEDs, 1,712 AEDs would need to be added to the existing 1,893, for a total of 3,605.

Using drones significantly reduced the time spent waiting for an AED. The researchers found that the reduction depended on both the number of drones deployed and their geographic positioning.

In the hybrid strategy combining fixed AEDs and drones, AED access times fell by an average of 3.76 minutes across all IRIS units. AEDs were delivered to more than 95% of OHCA cases within five minutes, compared with only 30% to 40% of cases when relying on transport from existing fixed AED locations via the road network.

The researchers estimated that using 200 drone bases and 871 fixed AED sites could extend AED coverage to nearly all OHCAs (28,349 cases), achieving an overall coverage rate of 99.4%.

Minka said, "Our study showed that drone delivery of AEDs could reduce the times to defibrillation across all the IRIS units by several minutes, with particularly large benefits in peripheral and highly congested areas. In some cases, the time saved exceeded 10 minutes.

"Our findings also suggest that this hybrid strategy could provide very broad territorial coverage while limiting the need to install hundreds of additional AEDs. This would increase the range to 3,900 meters (2.4 miles), compared to 500 meters (1,640 feet) for fixed AEDs only."

The researchers envision that the drones could be operated by specially trained people or automated systems under the supervision of emergency services. When a drone arrives at the scene of an OHCA, a bystander already present would collect the AED and start to use it on the patient, guided by emergency services.

"Drones will never replace bystanders, resuscitation efforts or emergency medical teams," Minka said. "However, they could represent an additional link in the chain of survival and help make defibrillation available more quickly.

"This study also shows that improving access to AEDs depends not only on the number of devices available, but also on how they are geographically distributed and organized. In some areas, drones could therefore represent a complementary strategy to large-scale deployment of additional fixed AEDs."

She said the study's findings would need to be confirmed in prospective studies and real-world experiments.

"Our findings highlight the potential value of investing in innovative solutions aimed at reducing inequalities in access to emergency care and optimizing the geographical distribution of emergency resources," she concluded.

A strength of the study is that it analyzed seven departments of the Île-de-France region using a detailed geospatial approach based on real-world cardiac arrest data. A limitation is that it is a simulation study: No drones were deployed, so their performance is based on theoretical models.

Drone travel time was estimated using straight-line distances ("as the crow flies") and therefore did not account for regulatory, meteorological or operational constraints that could influence real-world deployment.

Dr. Felix Lorang is a member of the EUSEM abstract selection committee. He is head of the emergency department at Klinikum Lippe in North Rhine-Westphalia, Germany, and was not involved with the research. He said, "Drones are being used for an increasingly wide range of purposes and this study shows how they could make an important contribution to the emergency services, enabling AEDs to reach people suffering heart attacks more quickly.

"However, it is vitally important that, in every country, as many members of the public as possible know how to provide cardiopulmonary resuscitation and how to use defibrillators. Without this training, someone suffering an out-of-hospital cardiac arrest would still have to wait for the arrival of the emergency services, even if an AED is positioned nearby or arrives quickly by drone."

More information

Hillary Minka, Optimizing automated external defibrillator access using drones: a geospatial analysis in the Paris region

Key medical concepts

Automated External DefibrillatorOut-of-Hospital Cardiac Arrest

Clinical categories

Emergency medicineCardiologyCommon illnesses & Prevention Provided by European Society for Emergency Medicine (EUSEM) Who's behind this story?

Sadie Harley

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Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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