Jack Johnson '22

For upwards of a decade, drones have been utilized in a variety of scenarios: aiding police in managing active shooter incidents, providing advanced intelligence for military resources, searching for lost hikers, and more. A more recent development, however, has been the use of drones in Emergency Medical Services (EMS). EMS personnel often respond to emergencies with minimal information and minimal resources. Drones can change that.

The primary—and most obvious—way that drones can aid EMS is by providing reconnaissance. When responding to an emergency, EMS personnel are often equipped with only minimal, and often incorrect, information. This information is gathered and passed along like a game of telephone; from the patient to the caller to the call center to the dispatcher and finally to the responding EMS crew. By the end, the true nature of the emergency may have changed or been lost altogether. In my own experience as an EMT, this can be detrimental to both patient care and, even more importantly, the safety of the crew.

Drones have numerous advantages over ground personnel in terms of establishing fast and effective situational awareness. Drones can provide wide-angle, aerial views of complex and dynamic emergency scenes. With evolving technology, some drones are outfitted with advanced thermal sensors, giving them the ability to locate patients in scenes with low visibility, such as at night, in storms, or in incidents with significant dispersion of patients, such as a boating accident.

In the aftermath of Hurricane Matthew in 2016, for example, the state of Georgia deployed many drones and unmanned aerial systems (UAS) to provide statewide, real-time intelligence to direct EMS resources to where they were needed most. On a smaller scale, drones can accomplish something that a 911 caller cannot accurately assess: they can be used at motor vehicle accidents to determine the number of patients involved, helping the responding team allocate the correct amount of resources to the incident.

The second—and slightly less obvious—way drones can support EMS is with advanced payload delivery. Many people think that EMS is all about speed—yes, speed is something that EMS crews think about while on an emergency scene, but it is only one factor of patient care. In the majority of EMS responses, the common wilderness medicine saying rings true: “Seconds never count and minutes rarely do.” There are, however, a few select cases in which speed is absolutely paramount for ensuring patient survival. In these situations, even an ambulance may not be fast enough.

In out-of-hospital cardiac arrest (where the patient’s heart stops beating entirely) the chance of survival decreases by up to 10% for every 60 seconds that the patient does not receive defibrillation (when a patient is shocked by a defibrillator in order to restore a normal cardiac rhythm). It is imperative that a cardiac arrest patient receives defibrillation as soon as possible; ideally, initial defibrillation is performed by a bystander, before EMS even arrives on scene. For this reason, automated external defibrillators (AEDs: a style of defibrillator that is user-friendly for the untrained bystander) are typically cached at public locations such as schools, sports stadiums, and parks.

This is where the high-speed capabilities of drones shine. Since AEDs can be used by untrained bystanders, they can be delivered directly to the scene of a cardiac arrest via drone. At this point, a bystander can provide rapid defibrillation to the cardiac arrest patient, drastically increasing odds of survival.

Directly delivering the AED to a scene via drone when an ambulance is 5-10 minutes away sounds like expensive overkill. It is crucial to understand that in this case, however, the 2 minutes that it takes to locate and retrieve an AED from the building across the street could have been the only window in which the patient retained a shockable rhythm and was still viable for defibrillation.

Studies performed in Canada, the United States, and Sweden have all come to similar conclusions: the delivery of AED by high-speed medical drones (some prototypes reaching a cruising speed of well over 60 mph) decreased mean response times to out-of-hospital cardiac arrests by between 16 and 20 minutes. In other words, the drones blew the ambulances out of the water in terms of speed.

As with all evolving technologies, there are issues with drones. Crashes as the result of both human error and automated systems, avoiding no-fly-zones, financial investment, and Federal Aviation Administration (FAA) restrictions all are obstacles that must be overcome in order for drones in EMS to become a reality. However, with some U.S. cities already beginning testing phases of drone programs, the concept may soon become a reality.

Bibliography

American Heart Association. (n.d.). CPR Facts & Stats [Fact sheet]. American Heart Association. Retrieved August 23, 2020, from https://cpr.heart.org/en/resources/cpr-facts-and-stats

EMS1 Staff. (2017, September 8). First responders increasing use of drones to save lives. EMS1. https://www.ems1.com/ems-products/technology/articles/first-responders-increasing-use-of-drones-to-save-lives-bFJYrrnFzJwSpGND/

Friese, G., NRP. (2018, March 29). Research: Drone video is effective in identifying multiple vehicle collision hazards. FireRescue1. https://www.firerescue1.com/emergency-response-in-the-drone-age/articles/research-drone-video-iseffective-in-identifying-multiple-vehicle-collision-hazards-ZKNeDySJ6DnoB5Le/

Transforming cardiac emergency care with drone delivery of AEDs. (2018, February 22). U.S. Fire Administration. Retrieved August 23, 2020, from https://www.usfa.fema.gov/current_events/022218.html

Wolfberg, D. (2019). EMS Lawline: Legal Questions Arise in EMS Drone Use. Journal of Emergency Medical Services. https://www.jems.com/2019/12/13/ems-lawline-legal-questions-arise-in-ems-drone-use/

Worrell, M. (2017, April 22). Advancing UAS technologies in all public safety disciplines. FireRescue1.https://www.firerescue1.com/fire-products/drones/articles/advancing-uas-technologies-in-all-public-safety-disciplines-Zg1IFohFrls2qJ7m/