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Multicenter Study
. 2016 Oct 12;24(1):124.
doi: 10.1186/s13049-016-0313-5.

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

A Claesson  1 , D Fredman  2 , L Svensson  2 , M Ringh  2 , J Hollenberg  2 , P Nordberg  2 , M Rosenqvist  3 , T Djarv  2 , S Österberg  2 , J Lennartsson  4 , Y Ban  4
Affiliations
Multicenter Study

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

A Claesson et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: 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. 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.

Methods: Data 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.

Results: In 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.

Discussion: The 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.

Conclusions: To 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.

Keywords: AED; Cardiac arrest; Defibrillation; Drone; EMS; UAV.

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Figures

Fig. 1
Fig. 1
EMS response time in OHCA, Stockholm County 2006–2013. Ambulance arrival time in minutes, Stockholm County 2006–2013. Non-crew witnessed, cardiac etiology, n = 4,385 cases
Fig. 2
Fig. 2
Suitable placement of UAV in an urban setting using a 50/50 weighting. Optimal placement of UAV, using a 50/50 weighting alternative. OHCA cases n = 3,041 between 2006–2013 in Stockholm County within a 10 km radius of point from optimal placement of UAV. Location #10 coincides with location #1 and was therefore excluded from visualisation in this figure
Fig. 3
Fig. 3
Suitable placement of UAV in rural setting using an 80/20 weighting. Optimal placement of UAV, using an 80/20 weighting alternative. OHCA cases n = 124 between 2006–2013 in Stockholm County within 10 km radius of point from optimal placement of UAV
Fig. 4
Fig. 4
AED delivery using an UAV system. Delivery of an AED in simulated OHCA from 3 m altitude using latch-release from an UAV
Fig. 5
Fig. 5
Flowchart of included cases. Flowchart of included cases. Final GIS analysis for optimal placement of UAV, n = 20 locations is based on non-crew witnessed cases with presumed cardiac etiology, n = 3,165 cases
See this image and copyright information in PMC

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