Cardiac & Resuscitation, Columns, Patient Care

Getting Medical Care to Patients Faster with Drones

Issue 4 and Volume 42.

The Research

Claesson A, Fredman D, Svensson L, et al. Unmanned aerial vehicles (drones) in out-of- hospital-cardiac-arrest. Scand J Trauma Resusc Emerg Med. 2016;24(1):124.

The Science

To explore the potential role of unmanned aerial vehicles (UAV), commonly known as drones, to deliver an automated external defibrillator (AED) to the scene of a cardiac arrest, the authors examined the global positioning system coordinates of out-of-hospital cardiac arrests in Stockholm County in Sweden. Geographical models were developed for the urban and rural areas, and test flights with an AED equipped drone were conducted over the rural areas.

Over a seven-year period (2006-2013), there were 3,165 cardiac arrests. Twenty sites were identified as being suitable for deploying a drone. When compared to the EMS response time, the urban model indicated the drone would have beat the ambulance to the scene 32% of the time by an average of 1.5 minutes. In the rural model, the drone arrived before EMS in 93% of the cases by an average of 19 minutes.

During the test flights, the researchers determined that dropping the AED from nine to 12 feet or landing the drone was safer than delivering the AED by parachute.

Medic Wesley Comments

I can see a boon of EMS cartoons being born from this study. “It’s all fun and games till the defib dropped on the rescuer’s head.”

Realistically, this is an idea that will need a great deal of research to implement. Currently, pilots of licensed aircraft are battling unrestricted use of drones in our country, citing the dangers associated with drone misuse. The flight industry will need convincing.

The goal is early defibrillation to out-of-hospital cardiac arrest patients. And theoretically, this provides the equipment to rural areas. I’m inclined to ask how much training has been offered to citizens in remote areas. Are rural first responders being recruited? To me, these are the first steps in a program for survival in rural areas. Yes, call me old school, but along with machines, I think we still need the people.

Doc Wesley Comments

The utility of using drones in emergency services has been advocated for, with a growing number of indications from aerial surveillance at mass gatherings of improved incident command and condition awareness when battling fires.

Although early drone use was limited to deploying a camera, larger drones have the capability of bringing life-saving equipment to the ill and injured. Drones are currently being used to drop floatation devices to near-drowning victims, and a prototype drone has already been tested that’s large enough to carry a single person. Therefore, the use of a drone to deliver an AED to the scene isn’t only feasible but it’s technically possible. But does it make sense?

A Google Maps search for Stockholm County, where this study was conducted, clearly shows the potential for this technology in this area, with its numerous islands and remote stretches where EMS is frequently an hour or more away.

Without question, this technology has its greatest utility in rural areas. However, cell phone coverage is often limited in these areas, making controlling the drone difficult unless using satellite phone technology. But why stop at AED use? Individual first aid kits with tourniquets, hemostatic bandages and pain medication could be delivered to trauma victims. Epinephrine auto-
injectors, bronchodilator inhalers and antihistamines could be sent to victims of anaphylaxis. Telecommunications equipment could be deployed to provide real-time patient evaluation and physician consultation.

Quite literally, the sky is the limit on this technology, and I’m excited to see the results of its implementation.