The impact of drone delivery of an automated external defibrillator: a simulation feasibility study

Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in Europe. Early defibrillation is associated with improved outcomes. While this may be delivered by members of the public using an automated external defibrillator (AED), they are used infrequently. Drone delivery of an AED may enable quicker defibrillation compared to awaiting arrival of emergency medical services. Little is known about how members of the public may react to AED delivery or about the potential impact of retrieving an AED on the provision of high-quality cardiopulmonary resuscitation (CPR).

A feasibility study using a simulated OHCA scenario was completed by members of the public. Participants performed CPR on a manikin, guided by an ambulance service call handler, which was interrupted by AED delivery. CPR quality and the duration of the interruption for AED retrieval were recorded, and participants' feedback on the scenario was collected using a survey.

Twelve participants completed the study. Overall, a median of 61% (interquartile range [IQR] 21-79) of chest compressions were delivered at the correct speed, and 99% (IQR 78-100) at the correct depth. CPR was discontinued for a median of 116 (96-135) seconds to retrieve an AED and deliver a shock. Participants described the scenario as stressful and challenging, were supportive of the concept of AED delivery by drone and emphasised the value of call-handler instructions and guidance.

This study demonstrated the feasibility of a process and outcomes evaluation of simulated drone-delivered AED to members of the public. The retrieval process was associated with notable interruption in the delivery of CPR, but it remains unknown whether any impact of this may be offset by expedited use of the AED. Understanding the likely overall impact of drone delivery of AEDs on patient outcomes is critical before this approach should be considered in clinical practice.