The Role of Drones in Out-of-Hospital Cardiac Arrest: A Scoping Review

Abstract

Drones may be able to deliver automated external defibrillators (AEDs) directly to bystanders of out-of-hospital cardiac arrest (OHCA) events, improving survival outcomes by facilitating early defibrillation. We aimed to provide an overview of the available literature on the role and impact of drones in AED delivery in OHCA. We conducted this scoping review using the PRISMA-ScR and Arksey and O’Malley framework, and systematically searched five bibliographical databases (Medline, EMBASE, Cochrane CENTRAL, PsychInfo and Scopus) from inception until February 28, 2022. After excluding duplicate articles, title/abstract screening followed by full text review was conducted by three independent authors. Data from the included articles were abstracted and analysed, with a focus on potential time savings of drone networks in delivering AEDs in OHCA, and factors that influence its implementation. Out of the 26 included studies, 23 conducted simulations or physical trials to optimise drone network configuration and evaluate time savings from drone delivery of AEDs, compared to the current emergency medical services (EMS), along with 1 prospective trial conducted in Sweden and 2 qualitative studies. Improvements in response times varied across the studies, with greater time savings in rural areas. However, emergency call to AED attachment time was not reduced in the sole prospective study and a South Korean study that accounted for weather and topography. With growing interest in drones and their potential use in AED delivery spurring new research in the field, our included studies demonstrate the potential advantages of unmanned aerial vehicle (UAV) network implementation in controlled environments to deliver AEDs faster than current EMS. However, for these time savings to translate to reduced times to defibrillation and improvement in OHCA outcomes, careful evaluation and addressing of real-world delays, challenges, and barriers to drone use in AED delivery is required.

Automatic External Defibrillator (AED) Location – seconds that save lifes

“…In this regard, solutions are being sought that involve delivering a de brillator to the home where it is located. This concept could be based on First Responders or use Drones [23][24][25][26][27]. Of course, in both cases it is necessary to use an effective communication response system starting with the medical dispatcher [21,23,26,27].…”

Current trends in the management of out of hospital cardiac arrest (OHCA)

“…Simulation studies also in suburban areas at a distance of 5 to10 km from the AED base were performed over time. The results were promising and research teams showed the feasibility of drone usage also in these conditions [6][7][8] . One of the few prospective studies on this theme was led by colleagues from Karolinska Institute.…”

Unmanned aerial vehicles and pre-hospital emergency medicine

“…[19]. Clear instruction, possibly by telephone dispatchers [20] and training and information campaigns via media and social media may be required to familiarise the public with delivered defibrillators [21][22][23]. Some initiatives have examined the possibility of delivery to the location of a mobile telephone to ensure an accurate delivery location and also delivering to community first responders to ensure that an effective user is immediately available to operate the defibrillator [24].…”