Optimizing a Drone Network to Deliver Automated External Defibrillators

Abstract

Background Public access defibrillation programs can improve survival after out-of-hospital cardiac arrest (OHCA), but automated external defibrillators (AEDs) are rarely available for bystander use at the scene. Drones are an emerging technology that can deliver an AED to the scene of an OHCA for bystander use. We hypothesize that a drone network designed with the aid of a mathematical model combining both optimization and queuing can reduce the time to AED arrival. Methods We applied our model to 53,702 OHCAs that occurred in the eight regions of the Toronto Regional RescuNET between January 1st 2006 and December 31st 2014. Our primary analysis quantified the drone network size required to deliver an AED one, two, or three minutes faster than historical median 911 response times for each region independently. A secondary analysis quantified the reduction in drone resources required if RescuNET was treated as one large coordinated region. Results The region-specific analysis determined that 81 bases and 100 drones would be required to deliver an AED ahead of median 911 response times by three minutes. In the most urban region, the 90th percentile of the AED arrival time was reduced by 6 minutes and 43 seconds relative to historical 911 response times in the region. In the most rural region, the 90th percentile was reduced by 10 minutes and 34 seconds. A single coordinated drone network across all regions required 39.5% fewer bases and 30.0% fewer drones to achieve similar AED delivery times. Conclusion An optimized drone network designed with the aid of a novel mathematical model can substantially reduce the AED delivery time to an OHCA event.

Delivery of Automated External Defibrillators (AED) by Drones: Implications for Emergency Cardiac Care

“…Research about AED-equipped drones is new and has primarily focused on time elements because rapid intervention is critical for patient outcomes [21•]. Drones may be safe and feasible for delivering an AED for out-of-hospital cardiac arrest using Geographic Information System (GIS) tools, which could automatically deploy drones [20•].…”

“…Finally, investigators reported no adverse events nor technical issues during any of the out-of-sight flights. Most recently, another group used geographical and mathematical models to design a drone network in a large area composed of rural and urban regions [21•]. Investigators used a theoretical drone network to quantify the drone network size required to deliver an AED faster than the median 911 times reported for the region.…”

“…Investigators used a theoretical drone network to quantify the drone network size required to deliver an AED faster than the median 911 times reported for the region. They found that a drone network reduced the median AED arrival time by 3 min compared to the historical 911 response and reduced the 90 percentile of AED arrival time by 10 min and 34 s in the most rural region and by 6 min and 43 s in the most urban region [21•]. …”

Year in Review in Cardiac Electrophysiology

“…Along these lines, Boutilier et al 26 investigated the possibility of using a drone network to optimize AED delivery to sites of out-of-hospital cardiac arrests efficiently to improve AED utilization ahead of historical 911 response times in Toronto. Using mathematical modeling, their primary analysis quantified the drone network size required to deliver an AED 1, 2, or 3 minutes faster than historical median 911 response times.…”

Optimal Strategies for Mitigating Sudden Cardiac Death Risk in At-risk Patients with Structural Heart Disease

“…63 More recently, the concept of having a drone network designed to deliver AEDs to the site of an out-of-hospital cardiac arrest has been modeled, with results demonstrating that such a strategy could result in the quicker availability of AEDs. 64 Further field testing is required to validate this interesting concept. One caveat, however, is that although having shorter AED response times should logically result in reduced SCD mortality, another study found that the deployment of AEDs in the homes of patients early after anterior MI did not result in reduced mortality compared with training family members in basic life support methods, suggesting that multiple factors influence the use of AEDs in the community.…”