Improving Access to Automated External Defibrillators in Rural and Remote Settings: A Drone Delivery Feasibility Study

Background Time to treatment is critical for survival from sudden cardiac arrest. Every minute delay in defibrillation results in a 7% to 10% reduction in survival. This is particularly problematic in rural and remote regions, where emergency medical service response is prolonged and automated external defibrillators (AEDs ) are often not available. Our primary objective was to examine the feasibility of a novelAED drone delivery method for rural and remote sudden cardiac arrest. A secondary objective was to compare response times betweenAED drone delivery and ambulance to mock sudden cardiac arrest resuscitations.Methods and Results We conducted 6 simulations in 2 rural communities in southern Ontario, Canada. In the first 2 simulations, the drone and ambulance were dispatched from the same paramedic base. In simulations 3 and 4, the drone and ambulance were dispatched from separate paramedic bases; and in simulations 5 and 6, the drone was dispatched from an optimized location. During each simulation, a “mock” call was placed to 911 and a singleAED drone and an ambulance were simultaneously dispatched to a predetermined destination. On scene, trained first responders retrieved theAED from the drone and initiated resuscitative efforts on a mannequin until paramedics arrived. No difficulties were encountered during drone activation by dispatch, ascent, landing, or bystander retrieval of theAED from the drone. During simulations 1 and 2, the distance to the scene was 6.6 km. For simulations 3 and 4, the ambulance response distance increased to 8.8 km while drone remained at 6.6 km; and in simulations 5 and 6, the ambulance response distance was 20 km compared with 9 km for the drone. During each flight, theAED drone arrived on scene before the ambulance, between 1.8 and 8.0 minutes faster.Conclusions This study suggestsAED drone delivery is feasible, with the potential for improvements in response time during simulated sudden cardiac arrest scenarios. Further research is required to determine the appropriate system configuration forAED drone delivery in an integrated emergency medical service system as well as optimal strategies to simplify bystander application of a drone‐deliveredAED .