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Research ArticleOriginal Articles

The Case for Drone-assisted Emergency Response to Cardiac Arrest

An Optimized Statewide Deployment Approach

Brittany M. Bogle, Wayne D. Rosamond, Kyle T. Snyder and Jessica K. Zègre-Hemsey
North Carolina Medical Journal July 2019, 80 (4) 204-212; DOI: https://doi.org/10.18043/ncm.80.4.204
Brittany M. Bogle
senior data scientist, IBM Corporation, Research Triangle Park, North Carolina
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  • For correspondence: bbogle@email.unc.edu
Wayne D. Rosamond
professor, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Kyle T. Snyder
director, NextGen Air Transportation Consortium, North Carolina State University, Raleigh, North Carolina
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Jessica K. Zègre-Hemsey
assistant professor, School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract

BACKGROUND Despite evidence linking rapid defibrillation to out-of-hospital cardiac arrest (OHCA) survival, bystander use of automatic external defibrillators (AEDs) remains low, due in part to AED placement and accessibility. AED-equipped drones may improve time-to-defibrillation, yet the benefits and costs are unknown.

METHODS We designed drone deployment networks for the state of North Carolina using mathematical optimization models to select drone stations from existing infrastructure by specifying the number of stations and the targeted AED arrival time. Expected outcomes were evaluated over the drone's lifespan (4 years). We estimated the following parameters: proportion of OHCAs within a targeted AED delivery time, bystander utilization of AEDs, survival/neurological status, and incremental cost per quality-adjusted life year (QALY).

RESULTS Statewide, 16,503 adults aged 18 or older were expected to experience OHCA with an attempted resuscitation over 4 years. Compared to no drone network, all proposed drone networks were expected to improve survival outcomes. For example, assuming 46% of OHCAs have bystanders willing to use an AED, a 500-drone network decreased the median time of defibrillator arrival from 7.7 to 2.7 minutes compared to no drone network. Expected survival rates doubled (24.5% versus 12.3%), resulting in an additional 30,267 QALYs ($858/incremental QALY). If just 4.5% of OHCAs had willing bystanders, 13.8% of victims would have survived. Sensitivity analysis demonstrated that an AED drone network remained cost-effective over a wide range of assumptions.

CONCLUSIONS With proper integration into existing systems, large-scale networks for drone AED delivery have the potential to substantially improve OHCA survival rates while remaining cost-effective. Public health researchers should consider advocating for feasibility studies and policy development surrounding drones.

  • ©2019 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
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North Carolina Medical Journal: 80 (4)
North Carolina Medical Journal
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July-August 2019
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The Case for Drone-assisted Emergency Response to Cardiac Arrest
Brittany M. Bogle, Wayne D. Rosamond, Kyle T. Snyder, Jessica K. Zègre-Hemsey
North Carolina Medical Journal Jul 2019, 80 (4) 204-212; DOI: 10.18043/ncm.80.4.204

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The Case for Drone-assisted Emergency Response to Cardiac Arrest
Brittany M. Bogle, Wayne D. Rosamond, Kyle T. Snyder, Jessica K. Zègre-Hemsey
North Carolina Medical Journal Jul 2019, 80 (4) 204-212; DOI: 10.18043/ncm.80.4.204
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