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Delivery of Automated External Defibrillators (AED) by Drones: Implications for Emergency Cardiac Care

  • Cardiovascular Risk Health Policy (W. Rosamond, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Out-of-hospital cardiac arrest (OHCA) remains a significant health problem in the USA and only 8.6% of victims survive with good neurological function, despite advances in emergency cardiac care. The likelihood of OHCA survival decreases by 10% for every minute without resuscitation.

Recent Findings

Automatic external defibrillators (AEDs) have the potential to save lives yet public access defibrillators are underutilized (< 2% of the time) because they are difficult to locate and rarely available in homes or residential areas, where the majority (70%) of OHCA occur. Even when AEDs are within close proximity (within 100 m), they are not used 40% of the time.

Summary

Unmanned aerial vehicles, or drones, have the potential to deliver AEDs to a bystander and augment emergency medical service (EMS) care. We review the use of drones in medicine, what is currently known, and clinical implications for advancing emergency cardiac care.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. Heart disease and stroke statistics—2016 update: a report from the American Heart Association. Circulation. 2015;133:e38–e360. https://doi.org/10.1161/cir.0000000000000350.

    Article  PubMed  Google Scholar 

  2. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135:e146–e1603. https://doi.org/10.1161/cir.0000000000000485.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Deakin CD, Shewry E, Gray HH. Public access defibrillation remains out of reach for most victims of out-of-hospital sudden cardiac arrest. Heart. 2014;100(8):619–23. https://doi.org/10.1136/heartjnl-2013-305030.

    Article  PubMed  Google Scholar 

  4. Daya MR, Schmicker RH, Zive DM, Rea TD, Nichol G, Buick JE, et al. Out-of-hospital cardiac arrest survival improving over time: results from the resuscitation outcomes consortium (ROC). Resuscitation. 2015;91:108–15. https://doi.org/10.1016/j.resuscitation.2015.02.003.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S315–67. https://doi.org/10.1161/cir.0000000000000252.

    Article  PubMed  Google Scholar 

  6. Weisfeldt ML, Everson-Stewart S, Sitlani C, Rea T, Aufderheide TP, Atkins DL, et al. Ventricular tachyarrhythmias after cardiac arrest in public versus at home. N Engl J Med. 2011;364(4):313–21. https://doi.org/10.1056/NEJMoa1010663.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. McCarthy JJ, Carr B, Sasson C, Bobrow BJ, Callaway CW, Neumar RW, et al. Out-of-hospital cardiac arrest resuscitation systems of care: a scientific statement from the American Heart Association. Circulation. 2018;137(21):e645–60.

    Article  PubMed  Google Scholar 

  8. Becker LB, Aufderheide TP, Graham R. Strategies to improve survival from cardiac arrest: a report from the Institute of Medicine. JAMA. 2015;314(3):223–4. https://doi.org/10.1001/jama.2015.8454.

    Article  CAS  PubMed  Google Scholar 

  9. Hansen SM, Hansen CM, Folke F, Rajan S, Kragholm K, Ejlskov L, et al. Bystander defibrillation for out-of-hospital cardiac arrest in public vs residential locations. JAMA Cardiol. 2017;2(5):507–14. https://doi.org/10.1001/jamacardio.2017.0008.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Strohle M, Paal P, Strapazzon G, Avancini G, Procter E, Brugger H. Defibrillation in rural areas. Am J Emerg Med. 2014;32(11):1408–12. https://doi.org/10.1016/j.ajem.2014.08.046.

    Article  PubMed  Google Scholar 

  11. Nelson RD, Bozeman W, Collins G, Booe B, Baker T, Alson R. Mobile versus fixed deployment of automated external defibrillators in rural EMS. Prehosp Disaster Med. 2015;30(2):152–4. https://doi.org/10.1017/s1049023x1500014x.

    Article  PubMed  Google Scholar 

  12. Portner ME, Pollack ML, Schirk SK, Schlenker MK. Out-of-hospital cardiac arrest locations in a rural community: where should we place AEDs? Prehosp Disaster Med. 2004;19(4):352–5. discussion 5

    Article  PubMed  Google Scholar 

  13. Smith CM, Lim Choi Keung SN, Khan MO, Arvanitis TN, Fothergill R, Hartley-Sharpe C, et al. Barriers and facilitators to public access defibrillation in out-of-hospital cardiac arrest: a systematic review. Eur Heart J Qual Care Clin Outcomes. 2017;3(4):264–73. https://doi.org/10.1093/ehjqcco/qcx023.

    Article  PubMed  Google Scholar 

  14. Malta Hansen C, Kragholm K, Pearson DA, Tyson C, Monk L, Myers B, et al. Association of bystander and first-responder Intervention with survival after out-of-hospital cardiac arrest in North Carolina, 2010-2013. JAMA. 2015;314(3):255–64. https://doi.org/10.1001/jama.2015.7938.

    Article  CAS  PubMed  Google Scholar 

  15. Van de Voorde P, Gautama S, Momont A, Ionescu CM, De Paepe P, Fraeyman N. The drone ambulance [A-UAS]: golden bullet or just a blank? Resuscitation. 2017;116:46–8. https://doi.org/10.1016/j.resuscitation.2017.04.037.

    Article  PubMed  Google Scholar 

  16. • Claesson A, Bäckman A, Ringh M, et al. Time to delivery of an automated external defibrillator using a drone for simulated out-of-hospital cardiac arrests vs emergency medical services. JAMA. 2017;317(22):2332–4. https://doi.org/10.1001/jama.2017.3957. The purpose of this pilot study was to compare delivery times of autonomous flying drones equipped with AEDs versus EMS in simulated OHCA. Investigators conducted eighteen flights to test the feasibility of autonomous drones equipped with AEDs and concluded it was feasible to fly drones equipped with AEDs in out-of-sight flights.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dyveke W, Kathryn T. Drones in sight: rapid growth through M&A’s in a soaring new industry. Strateg Dir. 2016;32(6):37–9. https://doi.org/10.1108/SD-04-2016-0044.

    Article  Google Scholar 

  18. Balasingam M. Drones in medicine-the rise of the machines. Int J Clin Pract. 2017;71(9). https://doi.org/10.1111/ijcp.12989.

    Article  Google Scholar 

  19. Hart A, Chai PR, Griswold MK, Lai JT, Boyer EW, Broach J. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management. Am J Disaster Med. 2017;12(4):261–5. https://doi.org/10.5055/ajdm.2017.0279.

    Article  PubMed  Google Scholar 

  20. • Bhatt K, Pourmand A, Sikka N. Targeted applications of unmanned aerial vehicles (drones) in telemedicine. Telemed J E Health. 2018; https://doi.org/10.1089/tmj.2017.0289. This comprehensive review identified UAV application in medicine in three categories: prehospital emergency care, expediting laboratory diagnostic testing, and surveillance. Authors concluded that UAVs have the potential to both access and quality of healthcare for patients otherwise restricted due to cost, distance, or infrastructure.

  21. • Boutilier JJ, Brooks SC, Janmohamed A, Byers A, Buick JE, Zhan C, et al. Optimizing a drone network to deliver automated external defibrillators. Circulation. 2017; https://doi.org/10.1161/circulationaha.116.026318. Investigators describe a hypothestical drone network based on mathematical modeling designed to reduce time to AED arrival. Their primary analysis quantified the drone network size required to deliver an AED in one, two, or three minute faster than historical median 911 times across Toronto regions.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Menees DS, Peterson ED, Wang Y, Curtis JP, Messenger JC, Rumsfeld JS, et al. Door-to-balloon time and mortality among patients undergoing primary PCI. N Engl J Med. 2013;369(10):901–9. https://doi.org/10.1056/NEJMoa1208200.

    Article  CAS  PubMed  Google Scholar 

  23. • Pulver A, Wei R, Mann C. Locating AED enabled medical drones to enhance cardiac arrest response times. Prehosp Emerg Care. 2016;20(3):378–89. https://doi.org/10.3109/10903127.2015.1115932. Investigators developed a geographical approach using drones equipped with AEDs. Their goal was to have one drone on scene within one minute for at least 90% of the demand while minimizing implementation costs. Maximum Coverage Location Problem model was used to determine the best configuration of drones to increase service. Using a combination of current EMS sites and new locations to launch drones equipped with AEDs would result in 90.3% of demand being reached within a minute.

    Article  PubMed  Google Scholar 

  24. Blewer AL, Abella BS. Unmeasured interface in emergency cardiovascular care: how do dispatch-assisted telephone cardiopulmonary resuscitation and bystander training interact? Circulation. 2018;137(10):996–8. https://doi.org/10.1161/circulationaha.117.030895.

    Article  PubMed  Google Scholar 

  25. Fukushima H, Panczyk M, Spaite DW, Chikani V, Dameff C, Hu C, et al. Barriers to telephone cardiopulmonary resuscitation in public and residential locations. Resuscitation. 2016;109:116–20. https://doi.org/10.1016/j.resuscitation.2016.07.241.

    Article  PubMed  Google Scholar 

  26. Transportation USDo. Federal Aviation Administration. Getting started. 2018. https://www.faa.gov/uas/getting_started/. Accessed 7 Aug 2018.

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Author information

Authors and Affiliations

  1. School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, Campus Box 7460, Chapel Hill, NC, 27599-7460, USA

    Jessica K. Zègre-Hemsey

  2. Research Collaborator, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Brittany Bogle

  3. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Christopher J. Cunningham

  4. NextGen Air Transportation Consortium, North Carolina State University, Raleigh, USA

    Kyle Snyder

  5. Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Wayne Rosamond

Authors
  1. Jessica K. Zègre-Hemsey
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  2. Brittany Bogle
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  3. Christopher J. Cunningham
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  4. Kyle Snyder
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  5. Wayne Rosamond
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Corresponding author

Correspondence to Jessica K. Zègre-Hemsey.

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Conflict of Interest

The project described was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through grant award numbers KL2TR002490 and UL1TR002489. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This is TraCS Pilot award grant no. UNCSUR31707.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Cardiovascular Risk Health Policy

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Zègre-Hemsey, J.K., Bogle, B., Cunningham, C.J. et al. Delivery of Automated External Defibrillators (AED) by Drones: Implications for Emergency Cardiac Care. Curr Cardiovasc Risk Rep 12, 25 (2018). https://doi.org/10.1007/s12170-018-0589-2

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  • DOI: https://doi.org/10.1007/s12170-018-0589-2

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