Out-of-Hospital Cardiac Arrest Treated with a Drone-Delivered Defibrillator Before Ambulance Arrival: A Narrative Review of Bystander Response Systems
DOI:
https://doi.org/10.5281/zenodo.22237025Keywords:
Out-of-Hospital Cardiac Arrest, Automated External Defibrillator, Drone Delivery, Bystander Response, Time to DefibrillationAbstract
Survival after cardiac arrest outside hospital falls by roughly a tenth for every minute without treatment, and the ambulance takes
about eleven. Flying a defibrillator to the scene is an obvious idea that has now been tested in real emergencies, with results that
are genuinely encouraging and much smaller than the coverage suggests.
Objectives: To review the published evidence on drone-delivered automated external defibrillators: whether delivery is feasible,
how much time is saved, how often a delivered device is actually used on a patient, and where this sits against the rest of the
bystander response system.
Material and Methods: Narrative review of prospective clinical studies, observational series, simulation studies, geographical
modelling and resuscitation guidance indexed in PubMed and the major cardiology and resuscitation journals. No new patient
data were generated; every estimate quoted is one published by the original investigators.
Results: In the first prospective clinical study, 14 of 53 alerts were eligible, drones took off in 12, and delivery succeeded in 11
(92 per cent). The drone arrived before the ambulance in 64 per cent of successful deliveries, with a median time benefit of 1
minute 52 seconds. In a larger subsequent series with both arrival times available in 55 cases, the drone arrived first in 37 (67
per cent) with a median benefit of 3 minutes 14 seconds; 18 were true arrests, a delivered device was attached in 6, two were
defibrillated before ambulance arrival, and one survived to 30 days.
Conclusion: Delivery works and saves clinically meaningful time. The attrition between a device landing and a shock being
delivered is severe, and it is not a technical problem: it depends on a bystander willing to collect the device and apply it. That,
rather than the aircraft, is where the remaining gain lies.
Abbreviations: AED – Automated External Defibrillator, CPR – Cardiopulmonary Resuscitation, EMS – Emergency Medical
Services, IQR – Interquartile Range, OHCA – Out-of-Hospital Cardiac Arrest, ROSC – Return of Spontaneous Circulation.
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