Drone delivery of an automated external defibrillator – a mixed method simulation study of bystander experience

Abstract

Background Out-of-hospital cardiac arrest (OHCA) affects some 275,000 individuals in Europe each year. Time from collapse to defibrillation is essential for survival. As emergency medical services (EMS) response times in Sweden have increased, novel methods are needed to facilitate early treatment. Unmanned aerial vehicles (i.e. drones) have potential to deliver automated external defibrillators (AED). The aim of this simulation study was to explore bystanders’ experience of a simulated OHCA-situation where a drone delivers an AED and how the situation is affected by having one or two bystanders onsite. Methods This explorative simulation study used a mixed methodology describing bystanders’ experiences of retrieving an AED delivered by a drone in simulated OHCA situations. Totally eight participants were divided in two groups of bystanders a) alone or b) in pairs and performed CPR on a manikin for 5 minutes after which an AED was delivered by a drone at 50 m from the location. Qualitative data from observations, interviews of participants and video recordings were analysed using content analysis alongside descriptive data on time delays during bystander interaction. Results Three categories of bystander experiences emerged: 1) technique and preparedness, 2) support through conversation with the dispatcher, and 3) aid and decision-making. The main finding was that retrieval of an AED as delivered by a drone was experienced as safe and feasible for bystanders. None of the participants hesitated to retrieve the AED; instead they experienced it positive, helpful and felt relief upon AED-drone arrival and were able to retrieve and attach the AED to a manikin. Interacting with the AED-drone was perceived as less difficult than performing CPR or handling their own mobile phone during T-CPR. Single bystander simulation introduced a significant hands-off interval when retrieving the AED, a period lasting 94 s (range 75 s–110 s) with one participant compared to 0 s with two participants. Conclusion The study shows that it made good sense for bystanders to interact with a drone in this simulated suspected OHCA. Bystanders experienced delivery of AED as safe and feasible. This has potential implications, and further studies on bystanders’ experiences in real cases of OHCA in which a drone delivers an AED are therefore necessary.

Handling of Ventricular Fibrillation in the Emergency Setting

“…The availability of automated external defibrillators (AED) in public spaces and broad-scale training for lay persons about the use of the device may increase the current survival rate of 10% (Berg et al, 2019). In Scandinavia, there have been experiments with simulation practices using drones for the speedy delivery of AEDs with positive results and applying this method in real situations in future may improve the success rate of life saving as well (Sanfridsson et al, 2019). During a practice simulating outof-hospital circulatory collapse the results of resuscitations performed by elderly bystanders (average age: 75.5 years) were compared considering several aspects.…”

“…The bystanders did not have any prior training and the primary goal was to find out how modern telecommunication tools (smartphones, drones, AED) would affect their performance. Results showed that from the time of the circulatory collapse AED was placed on the simulated patients within 10 min and resuscitation started within 2.25 min (Sanfridsson et al, 2019).…”

A Systematic Review of Effectiveness of Automated External Defibrillators Delivered by Drones

“…The interview results showed that none of the participants hesitated to retrieve the AED; instead, they experienced positive, helpful and felt relief upon AED-drone arrival and were able to retrieve and attach the AED to a manikin. (Sanfridsson et al, 2019). 16,503 OHCA cases All drone networks were expected to improve survival outcomes.…”

“…Drone networks show the potentiality to greatly reduce life-saving equipment travel time for OHCA victims. Sanfridsson et al 2019 West Sweden,…”

Drones and digital adherence monitoring for community-based tuberculosis control in remote Madagascar: A cost-effectiveness analysis

“…The use of drones in global health settings has rapidly evolved in the last years. As drone technology applications continue to expand beyond the military and recreational sectors, it is foreseen that drones will have a significant role to play for healthcare delivery in high- and low-income countries where either urgency, such as in the case of organ transplantation or cardiac arrest, or transportation complexity, such as in the case of last-mile delivery for enclaved population will justify their use [ 12 , 13 ]. Drones also have the potential to revolutionize healthcare supply chain systems, facilitate surveillance in geographically challenging regions and support emergency response in face of life-threatening patient conditions or natural disasters [ 8 , 14 – 16 ].…”