Are drone-delivered AEDs the future of out-of-hospital cardiac arrest survival?

Are drone-delivered AEDs the future of out-of-hospital cardiac arrest survival?

February 21, 2020
Emergency Medicine
From the January/February issue of HealthCare Business News magazine

By Vivian Nguyen

According to 2018 statistics from the American Heart Association (AHA), the incidence of out-of-hospital cardiac events (OHCA) assessed by emergency medical services (EMS) personnel is only 141 people per 100,000 population.
Nationwide, between 180,000 and 400,000 deaths caused by cardiovascular disease overall are sudden, unpredictable cardiac deaths — many of which occur outside of the hospital and potentially are not assessed by EMS personnel at all.

Further research published in the journal Circulation confirmed automatic external defibrillators (AEDs) significantly improve survival after cardiac arrest episodes. For over 50 years, research has shown return of spontaneous circulation (ROSC) is not likely achieved via a defibrillator if the shock was delivered more than three minutes after pulseless, shockable rhythm onset. However, many organizations, including the AHA, have adopted the eight-minute standard, which is the target time from the dispatcher receiving the emergency call to arrival of a defibrillator on scene. Researchers tested this eight-minute standard and discovered that a mere reduction of one minute can save an additional 23 lives per year, and a reduction of two minutes save up to 51 more lives per year. So why set the bar at eight minutes?

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Traditionally, patients who need emergency defibrillation have two methods of obtaining a shock via AED: 1) a bystander who finds and accesses a static AED in a public location or 2) provided by EMS who arrive on scene. Time required for AED arrival is heavily impacted by AED accessibility and EMS coverage, especially in rural, less accessible regions, compared to urban areas.

Research examining AED accessibility and its effects on AED coverage over 17 years found that 61.8 percent of all cardiac arrests occurred in public locations. However, AED coverage in public locations decreased significantly by 53.4 percent outside of normal business hours such as evenings and weekends. Rural areas have even more difficulty accessing timely lifesaving treatment, due to far distances from a dispatch center in conjunction with decreased volume of public AEDs overall.

Drones are already being used worldwide after major natural disasters, including the Haiti earthquake in 2010, hurricane Sandy in 2012, and the Nepal earthquake in 2015, delivering small aid packages across terrain that was unsafe via land travel. Since then, the uses of drones to assist in efficient, cost-effective delivery of healthcare have been countless. Previous studies have already proved that drones are a safe and feasible alternative for providing delivery of blood products, vaccines, and testing kits, especially to communities with poor road systems, disease endemic areas, or that have limited healthcare provider availability. Theoretically, if drones can deliver AEDs faster than traditional EMS response times to provide timely shocks, then OHCA mortality could decrease significantly. Are drones the future’s answer to saving lives?

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