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Time to delivery of an automated external defibrillator (AED) using a drone to improve out-of-hospital cardiac arrest (OHCA) mortality

10 August 2019


Background:According to the American Heart Association (AHA), 2018 incidence of out-of-hospital cardiac events (OHCA) that is assessed by emergency medical services (EMS) is 140.7 people per 100 000 population. The time it takes for AED arrival on scene is heavily impacted by AED accessibility and EMS coverage, especially in rural areas. Traditionally, patients who require defibrillation only have 2methods of obtaining a shock, which are via a bystander or provided by EMS, both of which take time to obtain. Theoretically, if drones can deliver AEDs faster than traditional EMS response times to provide more timely shocks, then OHCA mortality could decrease significantly.

Methods:An exhaustive literature search using the following engine searches was conducted: MEDLINE-PubMed, TRIP-Turning Research Into Practice, Web Science, and CINAHL using the search terms drones,AED(s), and defibrillator(s). These searches were screened using eligibility criteria and were critically appraised and assessed for quality using GRADE guidelines.

Results: A systematic review was conducted and 3 observational studies were ultimately included. One study found using pre-existing EMS infrastructure in addition to establishment of new drone launch sites was the most efficient method, which provided 90.3% coverage within the 1-minute time frame. Another study assessed a region-specific network, which revealed that AED-equipped drones arrived before emergency responders in 94.6% of cases for the 3-minute response reduction goal. The other study found that drones in rural locations were predicted to arrive with an AED before EMS responders in 93% of OHCA cases, which saved an average of 19 minutes travel time.

Conclusion:Given the current evidence and future research to be done, integrating a drone network to deliver AEDs to increase accessibility to the public in different settings is a feasible addition to existing EMS infrastructure to help save lives. However, public acceptance and policy change would be required to implement a medical drone network to deliver AEDs. Future studies need to be conducted that control for many confounding factors in order to properly assess the efficacy of drone-delivered AEDs to OHCA mortality rate specifically.

Keywords: Drones, AED(s), defibrillator(s)


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