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June 19, 2017

In a race to save lives post-cardiac arrest, drones may beat ambulances 93% of the time

Daily Briefing

Using drones to deliver automated external defibrillators (AEDs) to people in cardiac arrest could drastically cut the time between when patients experience cardiac arrest and when they get a potentially lifesaving electric shock, according to new research in JAMA.

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According to the Los Angeles Times, the best treatment for someone experiencing cardiac arrest is an electric shock, which jolts the heart back into a normal rhythm. But timing is crucial: the chances of survival cardiac arrest are about 90 percent if the individual receives an electric shock within a minute of cardiac arrest, but fall to below 5 percent if the shock is not administered within 10 minutes.

In 2016, more than 350,000 people experienced an out-of-hospital cardiac arrest (OHCA), according to the American Heart Association, and of those, just 12 percent lived long enough to get treatment at a hospital and be discharged. That means in many cases, people experiencing cardiac arrest are waiting on an AED to come to them, the Times reports—and that means they are frequently waiting on an ambulance.

Study details

For the study, researchers in Sweden compared the speed of AED delivery via ambulance with AED delivery via drone.

To do so, the researchers used the Swedish Registry for Cardiopulmonary Resuscitation to review ambulance response times to cardiac arrests in 18 rural areas between 2006 and 2014. The researchers then mirrored those responses with the drone, which launched from a fire station about 45 minutes outside of Stockholm.

The researchers designed the study so that the drone was activated by a dispatcher after someone made an emergency call. According to the Times, the 12.5-pound drone can reach speeds of up to 47 mph. The drone uses autopilot software, GPS, and a camera to reach its destination. The drone is also designed to be highly visible, with florescent paint and LED lights. 

Study results

In each instance, the researchers found that the drone arrived more quickly than it had taken the ambulance to arrive, cutting response time by a median of 16:39 minutes. 

Specifically, the drone took between 1:15 minutes and 11:51 minutes to reach the location of the cardiac arrest, with an average overall time of 5:21 minutes between dispatch and arrival. In contrast, the ambulances took between five and 38 minutes to reach the same locations, with an average overall time of 22 minutes. The researchers also found that the median time between dispatch and drone launch was three seconds, compared with three minutes for the ambulance.

Based on the findings, the researchers concluded that a drone would on average arrive more quickly than an ambulance 93 percent of the time.

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Andreas Claesson, lead author on the study and a paramedic, said the researchers were cautiously optimistic about the results, but they acknowledged that further testing is needed. "Saving 16 minutes is likely to be clinically important," the researchers wrote. "Nonetheless, further test flights, technological development, and evaluation of integration with dispatch centers and aviation administrators are needed."

Claesson also acknowledged that it's unclear how bystanders will interact with the drones in a real-life situation. He pointed out that while a drone might deliver an AED, that doesn't mean there will necessarily be a medical professional nearby to administer it. In fact, as the average person suffering cardiac arrest is a 70-year-old man, the patient's spouse will most likely be the one using the device.

But on the flipside, while those people might not be trained on how to use an AED, Claesson suggested that the dispatchers could walk them through the process on the phone. "We know that health care professional CPR is better than layman (CPR)," he said. "But we still believe that if we can deliver a defibrillator within five minutes, the proportion of people with shockable rhythms could be pretty high"(Commins, HealthLeaders Media, 6/13; Kaplan, Los Angeles Times, 6/13; Columbus, "Shots," NPR, 6/13).

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