In the future, drones could deliver defibrillators to cardiac arrest calls before first responders arrive.
“We had drones, we had defibrillators, there are ambulances, there are dispatch centers, we had all of those components. But we had to get all of that together,” said Andreas Claesson, a registered nurse and professor at Karolinska Institutet in Stockholm.
Sweden is one of the first places to develop an AED drone delivery program. Claesson has been a part of the program and subsequent studies since it started in 2014.
Over a span of four months a couple years ago, they made 11 deliveries and published the results in a study.
“That was the first study to show that it's feasible,” he said.
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“We are still in the project. We have seven drones now,” Claesson said. “In cardiac arrest in Sweden, we dispatch two ambulances and one fire truck and, as a complement, a drone.”
When dispatch gets a call for a possible cardiac arrest, the drone gets an automated alert. The drone then boots up and the pilot is notified. The delivery is mostly autonomous, based on the coordinates received by the dispatch center.
“The drone is airborne at the same time as the ambulance leaves the garage,” Claesson said.
The drone flies to the site, drops to 30 meters and lowers the AED.
“Early defibrillation is known to increase survival heavily. If we are able to deliver an AED and use it within three to five minutes of a cardiac arrest, 50% could survive,” Claesson said.
Studies show out-of-hospital cardiac arrest survival rates in adults sit at about 10%.
“Survival is pretty poor and has changed somewhat, but not a lot, in the past 30 years,” said Dr. Monique Starks, a cardiologist and associate professor of medicine at the Duke University School of Medicine.
Starks is in the beginning stages of working on a similar program in North Carolina.
“We determined that we could move the arrival times from about 8 to 10 minutes down to about 5 minutes,” she said, comparing the arrival times of first responders and AED-delivering drones.
They plan to start testing in the next one to two months after they have analyzed optimal drone placement based on historic cardiac arrest data in North Carolina.
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She said the biggest hurdle right now is current drone regulations put in place by the Federal Aviation Administration. Right now, drone operators have to keep the drone in a visual line of sight. Starks expects this rule could change over the next few years.
Another hurdle, Claesson said, is public education on AEDs, because not everyone knows how to use them. When the device arrives, someone on site needs to know how to use it if a first responder has not arrived yet.
Still, drones provide a lot of opportunities, especially for minority groups.
“African Americans and Hispanic groups are far more likely to have cardiac arrest, and are far less likely to survive,” Starks said. “Drones are likely to be very equitable for these minority subgroups.”
Starks said she is working on a study looking at areas where minorities are more likely to have cardiac arrests, and how drones are likely to get to these areas sooner.
Claesson is working on a study this year or next year to evaluate real clinical endpoints for drone AED deliveries.
The application of drones doesn’t stop at cardiac arrest.
“The innovation of using drones for early delivery of something could be applied to other conditions as well,” Claesson said.
