A study in Denmark has demonstrated the potential for deploying semi-autonomous drones to deliver defibrillators to help people with cardiac arrest. A researcher involved in the study says that she cannot imagine that these systems will not eventually be implemented in certain areas, but a regulatory framework is required to support its development.
In the future, when someone experiences cardiac arrest, emergency services help might quite literally arrive from above. Not in the divine sense, but a drone swiftly flying to the scene carrying a potentially life-saving automated external defibrillator (AED).
The advances in drone technology and artificial intelligence make this virtually inevitable.
Researchers have taken significant strides towards realising this vision with a study that, for the first time in Denmark and second location globally, proves that drones can autonomously deliver defibrillators to the location where a person is experiencing cardiac arrest.
“This represents the future. The challenge is to determine how to explore this potential further,” explains a researcher behind the study, Louise Kollander Jakobsen, PhD Fellow, Emergency Medical Services, Capital Region of Denmark, Ballerup.
The research has been published in Resuscitation.
Study needed
Researchers and health professionals worldwide are exploring the use of drones to rapidly deliver defibrillators to the non-hospital location where individuals experience cardiac arrest. Calculations suggest that this approach could not only save lives but also improve outcomes, reducing the likelihood of long-term disability following cardiac arrest.
However, beyond two studies from Sweden, no studies have tested the deployment of autonomous or semi-autonomous drones equipped with defibrillators to real-life cardiac arrest emergencies.
“The prediction models are encouraging. In addition, drones are becoming faster, more affordable, increasingly robust and have more advanced software in general. Studies are now required to test the integration of drones into existing emergency services, confirm that they can reliably deliver defibrillators – and that is precisely what this study aimed to demonstrate,” says Louise Kollander Jakobsen.
Covering an area with 110,000 inhabitants
The researchers equipped a drone with a defibrillator. The drone covered a section of Aalborg, Denmark with a radius of 5 kilometres, encompassing 110,000 inhabitants.
The company Everdrone developed a system, which was eventually approved by the relevant authorities, that deployed the drone when the emergency medical dispatch centre received a call involving suspected cardiac arrest.
Once the drone was activated, it conducted numerous calculations, including assessing the route and weather conditions, before taking off.
The drone autonomously reached the reported location. A drone operator then assisted in identifying an appropriate location to position the defibrillator, which was lowered securely using a wire. Then the drone returned to its base.
“Approval and permission from the Danish Civil Aviation and Railway Authority were essential, since flying drones over populated areas is strictly regulated in Denmark. This resulted in restrictions of area, flight paths and altitude. The pilot study was conducted within controlled airspace – monitored zones managed by an air traffic control tower. For instance, if a medical or rescue helicopters entered the airspace, it would get priority and the drone was required to remain grounded or land,” explains Louise Kollander Jakobsen.
Arriving in less than five minutes
During the 10-month study, the emergency centre received 76 calls reporting cardiac arrest outside hospital; 49 of these were during the hours when the drone was operational. The drone could only be deployed between 8:00 and 22:00, because that was when the drone operators were on duty.
In 16 of these 49 cases, the drone was dispatched. In the remaining 33 cases, adverse weather conditions, technical problems or restrictions of airspace prevented the drone from being deployed.
When the drone took off, it reached the location of the cardiac arrest with an average time of 4:47 minutes. However, the defibrillator it delivered was not used in any of the emergencies.
In 13 cases, ambulances or medical response vehicles arrived before the drone. On average, the ambulances took 3:25 minutes to reach the location.
In the three cases in which the drone arrived first, it arrived 0:06, 0:39 and 2:25 minutes before the ambulance, respectively. In the latter two cases, volunteer responders (Heartrunners) with a defibrillator arrived before the drone.
Drones even quicker today
Although the drone was only deployed in one third of the cases in which it could have been useful, and the defibrillator delivered was not used in any of these, Louise Kollander Jakobsen still considers the study a success. The drone used was a minimal viable product developed for testing purposes and therefore not super advanced.
She highlights that the drone covered a region with a major road leading to Aalborg University Hospital, with ambulances frequently present because of the proximity to the hospital.
On average, an ambulance arrives 6–8 minutes after being dispatched, so a response time of 3:25 minutes is remarkably fast- and optimal placement strategies will naturally be crucial to maximising the impact of the future dissemination of these systems. Moreover, drone technology has advanced substantially since the study concluded and more advanced models are now available.
Drones now calculate routes much more rapidly and fly faster. The drone used in the study could fly at 60 kilometres per hour, whereas newer models of the same type typically fly up to 90 kilometres per hour. In addition, they have become far more weather-resistant, especially in handling precipitation and wind.
“This study showed that drones equipped with defibrillators can be integrated into emergency response systems. This was our primary objective, and we succeeded, although we naturally would have preferred that the defibrillator had also made a difference,” notes Louise Kollander Jakobsen.
Regulatory barriers
Louise Kollander Jakobsen envisions that more research in this field will increasingly shed light on the role of drones in enhancing emergency response in many scenarios.
Drones equipped with defibrillators are standing by most of the time and could be used for other purposes, such as monitoring fires, road traffic accidents or water rescue operations.
In addition, seasonal factors might create specific circumstances requiring heightened emergency preparedness, such as in summer cottage areas during summer.
“The technology behind drones is advanced, and the study demonstrated that it can be integrated into emergency response systems. The major obstacle, however, is adapting the regulatory framework to accommodate their use in optimal locations – such as high-incidence areas with prolonged ambulance response times. This might involve radar systems to monitor drones or dedicated reserved airspace. Alternatively, drones could be fitted with sensors to coordinate their movements with each other. The regulatory aspect is lagging, which is why no country has yet fully committed to integrating drones into their emergency response systems,” concludes Louise Kollander Jakobsen.
