Sirens wail as responders race to apply a defibrillator shock to patients in cardiac arrest but often, they’re too late: Only 10% of people survive. But that could change, says industrial engineer Timothy Chan, a professor at the University of Toronto.
Drones that look like miniature helicopters, strategically placed at EMS, fire and police agencies, could beat ambulances to the scene by many minutes and, in some cases, cut response times in half according to new computer models.
When the heart stops beating, the chance of survival drops 7%–10% for every minute a defibrillator doesn’t deliver a lifesaving electrical shock to restart the heart, according to the American Heart Association. But ambulance response times are 5–10 minutes in cities and often over 20 minutes in rural communities, meaning firefighters, EMTs and paramedics often arrive too late.
A discussion with an emergency doctor sparked Chan to investigate if a drone could reduce response times. His team took historical ambulance response times to 56,000 cardiac arrests over a nine-year period and applied a mathematical algorithm to determine where drones would have to be placed to beat 9-1-1 responders.
Chan determined that a network of 81 drone bases with 100 drones would cut 90th percentile response times—the time it takes for ambulances to arrive in 90% of cardiac arrests—by more than half in southern Ontario. Rural regions would see response times drop from 19 minutes to nine minutes, and urban centers would see response times drop from just over 10 minutes to under four.
If drones could deliver defibrillators faster than ambulances, “thousands of lives could be saved,” says Renfrew Paramedic Chief Michael Nolan. “We’ve proven these concepts, now we need to integrate them within the regulatory framework.”
Nolan is ahead of the curve—he envisions a 9-1-1 system where pilots sit beside dispatchers to fly the drones remotely. His paramedics have been using drones to survey accident scenes since 2014, but they haven’t yet flown them “beyond line of sight.”
Transport Canada, the Canadian equivalent of the FAA, is working with Nolan on a regulatory framework for defibrillator-carrying drones. Intro Robotics, a drone maker, has supplied a prototype and applied for special exception to the current drone regulations.
Transport Canada spokesperson Natasha Gauthier says the idea that drones could help saves lives is “exciting” but warns that “they are aircraft, and should be treated as aircraft.” Transport Canada approaches each exemption request on case-by-case basis, paying close attention to proposed payloads that could fall out of the drone and other risks.
While public access defibrillators have proliferated in the last decade, only 20% of cardiac arrests occur in public places. For everyone else, defibrillator-carrying drones may soon be the difference between life and death.
After a decade working as a helicopter paramedic, Blair Bigham, MD, MSC, ACPF, completed medical school in Ontario, Canada, where he is now a resident physician in Hamilton.