1
|
Hanna DP, Erika B, Ellinor B, Sofia S, Leif S, Anette N, Jacob H, Andreas C. Dispatcher nurses' experiences of handling drones equipped with automated external defibrillators in suspected out-of-hospital cardiac arrest - a qualitative study. Scand J Trauma Resusc Emerg Med 2024; 32:74. [PMID: 39169425 PMCID: PMC11337748 DOI: 10.1186/s13049-024-01246-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/07/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Reducing the time to treatment by means of cardiopulmonary resuscitation (CPR) and defibrillation is essential to increasing survival after cardiac arrest. A novel method of dispatching drones for delivery of automated external defibrillators (AEDs) to the site of a suspected out-of-hospital cardiac arrest (OHCA) has been shown to be feasible, with the potential to shorten response times compared with the emergency medical services. However, little is known of dispatchers' experiences of using this novel methodology. METHODS A qualitative semi-structured interview study with a phenomenological approach was used. Ten registered nurses employed at an emergency medical dispatch centre in Gothenburg, Sweden, were interviewed and the data was analysed by qualitative content analysis. The purpose was to explore dispatcher nurses' experiences of deliveries of AEDs by drones in cases of suspected OHCA. RESULTS Three categories were formed. Nurses expressed varying compliance to the telephone-assisted protocol for dispatch of AED-equipped drones. They experienced uncertainty as to how long would be an acceptable interruption from the CPR protocol in order to retrieve a drone-delivered AED. The majority experienced that collegial support was important. Technical support, routines and training need to be improved to further optimise action in cases of drone-delivered AEDs handled by dispatcher nurses. CONCLUSIONS Although telephone-assisted routines for drone dispatch in cases of OHCA were available, their use was rare. Registered nurses showed variable degrees of understanding of how to comply with these protocols. Collegial and technical support was considered important, alongside routines and training, which need to be improved to further support bystander use of drone-delivered AEDs. As the possibilities of using drones to deliver AEDs in cases of OHCA are explored more extensively globally, there is a good possibility that this study could be of benefit to other nations implementing similar methods. We present concrete aspects that are important to take into consideration when implementing this kind of methodology at dispatch centres.
Collapse
Affiliation(s)
- Dalby-Pedersen Hanna
- Emergency Medical Services, Sjukhusen i Väster, Region Västra Götaland, Dumpergatan 3, Kungälv, Kungälv, 442 40, Sweden
| | - Bergström Erika
- Emergency Medical Services, Premedic Ånge, Region Västernorrland, Spångbrovägen 1, Ånge, 841 32, Sweden
| | - Berglund Ellinor
- Centre for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, Södersjukhuset, Stockholm, S-118 83, Sweden
| | - Schierbeck Sofia
- Centre for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, Södersjukhuset, Stockholm, S-118 83, Sweden
| | - Svensson Leif
- Department of Medicine, Karolinska Institutet, Solna, Stockholm, S-171 77, Sweden
| | - Nord Anette
- Centre for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, Södersjukhuset, Stockholm, S-118 83, Sweden
| | - Hollenberg Jacob
- Centre for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, Södersjukhuset, Stockholm, S-118 83, Sweden
| | - Claesson Andreas
- Centre for Resuscitation Science, Department of Clinical Science and Education, Karolinska Institutet, Sjukhusbacken 10, Södersjukhuset, Stockholm, S-118 83, Sweden.
| |
Collapse
|
2
|
McGuigan PJ. New indications for the use of drones in pre-hospital care; tackling two stones with one bird. Resuscitation 2024; 202:110344. [PMID: 39097077 DOI: 10.1016/j.resuscitation.2024.110344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Peter J McGuigan
- Royal Victoria Hospital, Belfast, UK; Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, UK.
| |
Collapse
|
3
|
Plodr M, Chalusova E. Current trends in the management of out of hospital cardiac arrest (OHCA). Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:105-116. [PMID: 38441422 DOI: 10.5507/bp.2024.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 06/16/2024] Open
Abstract
Sudden cardiac arrest remains a relevant problem with a significant number of deaths worldwide. Although survival rates have more than tripled over the last 20 years (4% in 2001 vs. 14% in 2020), survival rates with good neurological outcomes remain persistently low, representing a major socioeconomic problem. Every minute of delay from patient collapse to start cardiopulmonary resuscitation (CPR) and early defibrillation reduces the chance of survival by approximately 10-12%. Therefore, the time to treatment is a crucial factor in the prognosis of patients with out-of-hospital cardiac arrest (OHCA). Research teams working in the pre-hospital setting are therefore looking for ways to improve the transmission of information from the site of an emergency event and to make it easier for emergency medical dispatch centres (EMDC) to recognise life-threatening conditions with minimal deviation. For emergency unit procedures already at the scene of the event, methods are being sought to efficiently and temporarily replace a non-functioning cardiopulmonary system. In the case of traumatic cardiac arrest (TCA), the focus is mainly on effective affecting non-compressible haemorrhage.
Collapse
Affiliation(s)
- Michal Plodr
- Department of Emergency Medicine and Military General Medicine, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic
- Emergency Medical Services of the Hradec Kralove Region, Hradec Kralove, Czech Republic
| | - Eva Chalusova
- Department of Emergency Medicine and Military General Medicine, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czech Republic
| |
Collapse
|
4
|
Leith T, Correll JA, Davidson EE, Gottula AL, Majhail NK, Mathias EJ, Pribble J, Roberts NB, Scott IG, Cranford JA, Hopson LR, Hunt N, Brent CM. Bystander interaction with a novel multipurpose medical drone: A simulation trial. Resusc Plus 2024; 18:100633. [PMID: 38666251 PMCID: PMC11043843 DOI: 10.1016/j.resplu.2024.100633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/26/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Intro Medical drones are an emerging technology which may facilitate rapid treatment in time-sensitive emergencies. However, drones rely on lay rescuers, whose interactions with multipurpose medical drones have not been studied, and the optimal drone design remains unclear. Methods We conducted 24 simulations of adult out-of-hospital cardiac arrest (OHCA) and pediatric anaphylaxis with a prototype drone equipped with spoken and visual cues and a multipurpose medical kit. 24 layperson volunteers encountered one of the two scenarios and were supported through administering treatment by a simulated 911 dispatcher. Bystander-drone interactions were evaluated via a convergent parallel mixed methods approach using surveys, video event review, and semi-structured interviews. Results 83% (20/24) of participants voiced comfort interacting with the drone. 96% (23/24) were interested in future interaction. Participants appreciated the drone's spoken instructions but found visual cues confusing. Participants retrieved the medical kit from the drone in a mean of 5 seconds (range 2-14) of drone contact; 79% (19/24) found this step easy or very easy. The medical kit's layered design caused difficulty in retrieving appropriate equipment. Participants expressed a wide range of reactions to the unique drone design. Conclusions Laypeople can effectively and comfortably interact with a medical drone with a novel design. Feedback on design elements will result in further refinements and valuable insights for other drone designers. A multipurpose medical kit created more challenges and indicates the need for further refinement to facilitate use of the equipment.
Collapse
Affiliation(s)
- Thomas Leith
- Department of Emergency Medicine, University of Massachusetts, 55 Lake Street, Worcester, MA 01604, United States
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Jason A. Correll
- University of Michigan Medical School, 1515 E Medical Center Dr, Ann Arbor, MI 48109, United States
| | - Emma E. Davidson
- University of Michigan School of Nursing, 426 North Ingalls Street, Ann Arbor, MI 48109, United States
- Emergent Health Partners, LLC, 1200 State Circle, Ann Arbor, MI 48108, United States
| | - Adam L. Gottula
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
- Department of Anesthesiology, Division of Critical Care, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Noor K. Majhail
- College of Literature, Science and the Arts, University of Michigan, 500 S State St, Ann Arbor, MI 48109, United States
- Emergent Health Partners, LLC, 1200 State Circle, Ann Arbor, MI 48108, United States
| | - Emily J. Mathias
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - James Pribble
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Nathan B. Roberts
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Isabella G. Scott
- College of Literature, Science and the Arts, University of Michigan, 500 S State St, Ann Arbor, MI 48109, United States
| | - James A. Cranford
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Laura R. Hopson
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Nathaniel Hunt
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Christine M. Brent
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, United States
| |
Collapse
|
5
|
Kienbacher CL, Schreiber W, Herkner H, Holzhacker C, Chwojka CC, Tscherny K, Egger A, Fuhrmann V, Niederer M, Neymayer M, Bernert L, Gamsjäger A, Grünbeck I, Heitger MB, Saleh L, Schmidt S, Schönecker S, Wirth D, Williams KA, Roth D. Drone-Facilitated Real-Time Video-Guided Feedback Helps to Improve the Quality of Lay Bystander Basic Life Support. A Randomized Controlled Simulation Trial. PREHOSP EMERG CARE 2024:1-7. [PMID: 38776259 DOI: 10.1080/10903127.2024.2351970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVES Telephone instructions are commonly used to improve cardiopulmonary resuscitation (CPR) by lay bystanders. This usually implies an audio but no visual connection between the provider and the emergency medical telecommunicator. We aimed to investigate whether video-guided feedback via a camera drone enhances the quality of CPR. METHODS We conducted a randomized controlled simulation trial. Lay rescuers performed 8 min of CPR on an objective feedback manikin. Participants were randomized to receive telephone instructions with (intervention group) or without (control group) a drone providing a visual connection with the telecommunicator after a 2-min run-in phase. Performed work (total compression depth minus total lean depth) was the primary outcome. Secondary outcomes were the proportion of effective chest compressions, average compression depth, subjective physical strain measured every 2 min, and dexterity in the nine-hole peg test after the scenario. Outcomes were compared using the t- and Mann Whitney-U tests. A two-sided p-value of <0.05 was considered significant. RESULTS We included 27 individuals (14 (52%) female, mean age 41 ± 14 years). Performed work was greater in the intervention than in the control group (41.3 ± 7.0 vs. 33.9 ± 10.9 m; absolute difference 7.5, 95% CI 1.4 to 14.8; p = 0.046), with higher average compression depth (49 ± 7 vs. 40 ± 13 mm; p = 0.041), and higher proportions of adequate chest compressions (43 (IQR 14-60) vs. 3 (0-29) %; p = 0.041). We did not find any significant differences regarding the remaining secondary outcomes. CONCLUSION Video-guided feedback via drones might be a helpful tool to enhance the quality of telephone-assisted CPR in lay bystanders.
Collapse
Affiliation(s)
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | - Katharina Tscherny
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander Egger
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Verena Fuhrmann
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Maximilian Niederer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Marco Neymayer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Larissa Bernert
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexandra Gamsjäger
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Isabella Grünbeck
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Marietta B Heitger
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Line Saleh
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Sophie Schmidt
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Dilara Wirth
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Kenneth A Williams
- Department of Emergency Medicine, Division of Emergency Medical Services, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
6
|
Starks MA, Blewer AL, Chow C, Sharpe E, Van Vleet L, Arnold E, Buckland DM, Joiner A, Simmons D, Green CL, Mark DB. Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance. Circ Cardiovasc Qual Outcomes 2024; 17:e010061. [PMID: 38529632 PMCID: PMC11127748 DOI: 10.1161/circoutcomes.123.010061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 01/10/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopulmonary resuscitation (CPR) quality. METHODS Mock out-of-hospital cardiac arrest simulations that included a 9-1-1 call, CPR, and drone-delivered AED were conducted. Each simulation was timed and video-recorded. CPR performance metrics were recorded by a Laerdal Resusci Anne Quality Feedback System. Multivariable regression modeling examined factors associated with time from 9-1-1 call to AED shock and CPR quality metrics (compression rate, depth, recoil, and chest compression fraction). Comparisons were made among those with recent CPR training (≤2 years) versus no recent (>2 years) or prior CPR training. RESULTS We recruited 51 research participants between September 2019 and March 2020. The median age was 34 (Q1-Q3, 23-54) years, 56.9% were female, and 41.2% had recent CPR training. The median time from 9-1-1 call to initiation of CPR was 1:19 (Q1-Q3, 1:06-1:26) minutes. A median time of 1:59 (Q1-Q3, 01:50-02:20) minutes was needed to retrieve a drone-delivered AED and deliver a shock. The median CPR compression rate was 115 (Q1-Q3, 109-124) beats per minute, the correct compression depth percentage was 92% (Q1-Q3, 25-98), and the chest compression fraction was 46.7% (Q1-Q3, 39.9%-50.6%). Recent CPR training was not associated with CPR quality or time from 9-1-1 call to AED shock. Younger age (per 10-year increase; β, 9.97 [95% CI, 4.63-15.31] s; P<0.001) and prior experience with AED (β, -30.0 [95% CI, -50.1 to -10.0] s; P=0.004) were associated with more rapid time from 9-1-1 call to AED shock. Prior AED use (β, 6.71 [95% CI, 1.62-11.79]; P=0.011) was associated with improved chest compression fraction percentage. CONCLUSION Research participants were able to rapidly retrieve an AED from a drone while largely maintaining CPR quality according to American Heart Association guidelines. Chest compression fraction was lower than expected.
Collapse
Affiliation(s)
- Monique A Starks
- Department of Medicine, Duke University School of Medicine, Durham, NC (M.A.S.., D.B.M.)
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.A.S., C.L.G., D.B.M.)
| | - Audrey L Blewer
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC (A.L.B)
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC (A.L.B.)
| | - Christine Chow
- Department of Medicine, Duke University School of Medicine, Durham, NC (M.A.S.., D.B.M.)
| | | | | | - Evan Arnold
- Institute for Transportation Research and Education, North Carolina State University, Raleigh, NC (E.A.)
| | - Daniel M Buckland
- Department of Emergency Medicine Duke University School of Medicine, Durham, NC (D.M.B.,A.J.)
- Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC (D.M.B.)
| | - Anjni Joiner
- Department of Emergency Medicine Duke University School of Medicine, Durham, NC (D.M.B.,A.J.)
- Durham County EMS, NC (L.V.V., A.J.)
| | - Denise Simmons
- Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC (D.S.)
| | - Cynthia L Green
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC (C.L.G)
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.A.S., C.L.G., D.B.M.)
| | - Daniel B Mark
- Department of Medicine, Duke University School of Medicine, Durham, NC (M.A.S.., D.B.M.)
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (M.A.S., C.L.G., D.B.M.)
| |
Collapse
|
7
|
Zègre-Hemsey JK, Cheskes S, Johnson AM, Rosamond WD, Cunningham CJ, Arnold E, Schierbeck S, Claesson A. Challenges & barriers for real-time integration of drones in emergency cardiac care: Lessons from the United States, Sweden, & Canada. Resusc Plus 2024; 17:100554. [PMID: 38317722 PMCID: PMC10838948 DOI: 10.1016/j.resplu.2024.100554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Abstract
Importance Out-of-hospital cardiac arrest (OHCA) is a leading cause of morbidity and mortality in the US and Europe (∼600,000 incident events annually) and around the world (∼3.8 million). With every minute that passes without cardiopulmonary resuscitation or defibrillation, the probability of survival decreases by 10%. Preliminary studies suggest that uncrewed aircraft systems, also known as drones, can deliver automated external defibrillators (AEDs) to OHCA victims faster than ground transport and potentially save lives. Objective To date, the United States (US), Sweden, and Canada have made significant contributions to the knowledge base regarding AED-equipped drones. The purpose of this Special Communication is to explore the challenges and facilitators impacting the progress of AED-equipped drone integration into emergency medicine research and applications in the US, Sweden, and Canada. We also explore opportunities to propel this innovative and important research forward. Evidence review In this narrative review, we summarize the AED-drone research to date from the US, Sweden, and Canada, including the first drone-assisted delivery of an AED to an OHCA. Further, we compare the research environment, emergency medical systems, and aviation regulatory environment in each country as they apply to OHCA, AEDs, and drones. Finally, we provide recommendations for advancing research and implementation of AED-drone technology into emergency care. Findings The rates that drone technologies have been integrated into both research and real-life emergency care in each country varies considerably. Based on current research, there is significant potential in incorporating AED-equipped drones into the chain of survival for OHCA emergency response. Comparing the different environments and systems in each country revealed ways that each can serve as a facilitator or barrier to future AED-drone research. Conclusions and relevance The US, Sweden, and Canada each offers different challenges and opportunities in this field of research. Together, the international community can learn from one another to optimize integration of AED-equipped drones into emergency systems of care.
Collapse
Affiliation(s)
| | - Sheldon Cheskes
- Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Centre for Prehospital Medicine, Toronto, Ontario, Canada
| | - Anna M. Johnson
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, United States
| | - Wayne D. Rosamond
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, United States
| | | | - Evan Arnold
- North Carolina State University, Institute for Transportation Research and Education, United States
| | - Sofia Schierbeck
- Centre for Resuscitation Science, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Claesson
- Centre for Resuscitation Science, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
8
|
Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, Fernanda de Almeida M, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Daripa Kawakami M, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, John Madar R, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Gene Ong YK, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Resuscitation 2024; 195:109992. [PMID: 37937881 DOI: 10.1016/j.resuscitation.2023.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
Collapse
|
9
|
Surman K, Lockey D. Unmanned aerial vehicles and pre-hospital emergency medicine. Scand J Trauma Resusc Emerg Med 2024; 32:9. [PMID: 38287437 PMCID: PMC10826110 DOI: 10.1186/s13049-024-01180-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/14/2024] [Indexed: 01/31/2024] Open
Abstract
Unmanned aerial vehicles (UAVs) are used in many industrial and commercial roles and have an increasing number of medical applications. This article reviews the characteristics of UAVs and their current applications in pre-hospital emergency medicine. The key roles are transport of equipment and medications and potentially passengers to or from a scene and the use of cameras to observe or communicate with remote scenes. The potential hazards of UAVs both deliberate or accidental are also discussed.
Collapse
Affiliation(s)
| | - David Lockey
- Bartshealth NHS Trust, London, UK.
- Blizard Institute, Queen Mary University, London, UK.
- London's Air Ambulance, Barts Health NHS Trust, London, UK.
| |
Collapse
|
10
|
Sharma S, Sharma H. Drone a technological leap in health care delivery in distant and remote inaccessible areas: A narrative review. Saudi J Anaesth 2024; 18:95-99. [PMID: 38313723 PMCID: PMC10833029 DOI: 10.4103/sja.sja_506_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 06/11/2023] [Accepted: 06/11/2023] [Indexed: 02/06/2024] Open
Abstract
In developing countries, last-mile delivery of medical products is a challenge, especially in hilly and rural areas where there is no road connectivity. As helicopters or other air services are not affordable all the time, drones can be used for the supply of medical products. They are cost-effective as compared to other air or road transport. However, the carrying capacity of drone is less, it is not able to carry heavier payloads. Also, operating drones requires trained operators, and it is a new venture in a developing country so possibilities of confusion and lack of clarity on operating procedures are there. Drones are becoming increasingly reliable for the health care delivery. This narrative review explores the use of drones in healthcare delivery globally.
Collapse
Affiliation(s)
- Sanjana Sharma
- Department of Public Health, Bharti University, Durg, Chhattisgarh, India
| | - Hunny Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Raipur, Chhattisgarh, India
| |
Collapse
|
11
|
Johnson AM, Rosamond WD. What does the COVID-19 pandemic reveal about out-of-hospital cardiac arrest? Insights from the Canadian EMS response. Resuscitation 2024; 194:110096. [PMID: 38135015 DOI: 10.1016/j.resuscitation.2023.110096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Affiliation(s)
- Anna M Johnson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States.
| | - Wayne D Rosamond
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States
| |
Collapse
|
12
|
Berg KM, Bray JE, Ng KC, Liley HG, Greif R, Carlson JN, Morley PT, Drennan IR, Smyth M, Scholefield BR, Weiner GM, Cheng A, Djärv T, Abelairas-Gómez C, Acworth J, Andersen LW, Atkins DL, Berry DC, Bhanji F, Bierens J, Bittencourt Couto T, Borra V, Böttiger BW, Bradley RN, Breckwoldt J, Cassan P, Chang WT, Charlton NP, Chung SP, Considine J, Costa-Nobre DT, Couper K, Dainty KN, Dassanayake V, Davis PG, Dawson JA, de Almeida MF, De Caen AR, Deakin CD, Dicker B, Douma MJ, Eastwood K, El-Naggar W, Fabres JG, Fawke J, Fijacko N, Finn JC, Flores GE, Foglia EE, Folke F, Gilfoyle E, Goolsby CA, Granfeldt A, Guerguerian AM, Guinsburg R, Hatanaka T, Hirsch KG, Holmberg MJ, Hosono S, Hsieh MJ, Hsu CH, Ikeyama T, Isayama T, Johnson NJ, Kapadia VS, Kawakami MD, Kim HS, Kleinman ME, Kloeck DA, Kudenchuk P, Kule A, Kurosawa H, Lagina AT, Lauridsen KG, Lavonas EJ, Lee HC, Lin Y, Lockey AS, Macneil F, Maconochie IK, Madar RJ, Malta Hansen C, Masterson S, Matsuyama T, McKinlay CJD, Meyran D, Monnelly V, Nadkarni V, Nakwa FL, Nation KJ, Nehme Z, Nemeth M, Neumar RW, Nicholson T, Nikolaou N, Nishiyama C, Norii T, Nuthall GA, Ohshimo S, Olasveengen TM, Ong YKG, Orkin AM, Parr MJ, Patocka C, Perkins GD, Perlman JM, Rabi Y, Raitt J, Ramachandran S, Ramaswamy VV, Raymond TT, Reis AG, Reynolds JC, Ristagno G, Rodriguez-Nunez A, Roehr CC, Rüdiger M, Sakamoto T, Sandroni C, Sawyer TL, Schexnayder SM, Schmölzer GM, Schnaubelt S, Semeraro F, Singletary EM, Skrifvars MB, Smith CM, Soar J, Stassen W, Sugiura T, Tijssen JA, Topjian AA, Trevisanuto D, Vaillancourt C, Wyckoff MH, Wyllie JP, Yang CW, Yeung J, Zelop CM, Zideman DA, Nolan JP. 2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation 2023; 148:e187-e280. [PMID: 37942682 PMCID: PMC10713008 DOI: 10.1161/cir.0000000000001179] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The International Liaison Committee on Resuscitation engages in a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation and first aid science. Draft Consensus on Science With Treatment Recommendations are posted online throughout the year, and this annual summary provides more concise versions of the final Consensus on Science With Treatment Recommendations from all task forces for the year. Topics addressed by systematic reviews this year include resuscitation of cardiac arrest from drowning, extracorporeal cardiopulmonary resuscitation for adults and children, calcium during cardiac arrest, double sequential defibrillation, neuroprognostication after cardiac arrest for adults and children, maintaining normal temperature after preterm birth, heart rate monitoring methods for diagnostics in neonates, detection of exhaled carbon dioxide in neonates, family presence during resuscitation of adults, and a stepwise approach to resuscitation skills training. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the quality of the evidence, using Grading of Recommendations Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence-to-Decision Framework Highlights sections. In addition, the task forces list priority knowledge gaps for further research. Additional topics are addressed with scoping reviews and evidence updates.
Collapse
|
13
|
Stancati JA, Owyang CG, Araos JD, Agarwal S, Grossestreuer AV, Counts CR, Johnson NJ, Morgan RW, Moskowitz A, Perman SM, Sawyer KN, Yuriditsky E, Horowitz JM, Kaviyarasu A, Palasz J, Abella BS, Teran F. The Latest in Resuscitation Research: Highlights From the 2022 American Heart Association's Resuscitation Science Symposium. J Am Heart Assoc 2023; 12:e031530. [PMID: 38038192 PMCID: PMC10727320 DOI: 10.1161/jaha.123.031530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND Every year the American Heart Association's Resuscitation Science Symposium (ReSS) brings together a community of international resuscitation science researchers focused on advancing cardiac arrest care. METHODS AND RESULTS The American Heart Association's ReSS was held in Chicago, Illinois from November 4th to 6th, 2022. This annual narrative review summarizes ReSS programming, including awards, special sessions and scientific content organized by theme and plenary session. CONCLUSIONS By exploring both the science of resuscitation and important related topics including survivorship, disparities, and community-focused programs, this meeting provided important resuscitation updates.
Collapse
Affiliation(s)
| | - Clark G. Owyang
- Department of Emergency MedicineWeill Cornell Medicine/New York Presbyterian HospitalNew YorkNYUSA
- Division of Pulmonary and Critical Care MedicineWeill Cornell Medicine/New York Presbyterian HospitalNew YorkNYUSA
| | - Joaquin D. Araos
- Department of Clinical Sciences, College of Veterinary MedicineCornell UniversityIthacaNYUSA
| | - Sachin Agarwal
- Division of Neurocritical Care & Hospitalist NeurologyColumbia University Irving Medical CenterNew YorkNYUSA
| | | | | | - Nicholas J. Johnson
- Department of Emergency MedicineUniversity of WashingtonSeattleWAUSA
- Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of WashingtonSeattleWAUSA
| | - Ryan W. Morgan
- Division of Critical Care Medicine, Department of Anesthesiology and Critical Care MedicineChildren’s Hospital of PhiladelphiaPhiladelphiaPAUSA
| | - Ari Moskowitz
- Division of Critical Care MedicineMontefiore Medical CenterBronxNYUSA
| | - Sarah M. Perman
- Department of Emergency MedicineUniversity of Colorado School of MedicineAuroraCOUSA
| | - Kelly N. Sawyer
- Department of Emergency MedicineUniversity of PittsburghPittsburghPAUSA
| | - Eugene Yuriditsky
- Division of Cardiology, Department of MedicineNYU Langone HealthNew YorkNYUSA
| | - James M. Horowitz
- Division of Cardiology, Department of MedicineNYU Langone HealthNew YorkNYUSA
| | - Aarthi Kaviyarasu
- Department of Emergency Medicine, Center for Resuscitation ScienceUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Joanna Palasz
- Department of Emergency MedicineWeill Cornell Medicine/New York Presbyterian HospitalNew YorkNYUSA
| | - Benjamin S. Abella
- Department of Emergency Medicine, Center for Resuscitation ScienceUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Felipe Teran
- Department of Emergency MedicineWeill Cornell Medicine/New York Presbyterian HospitalNew YorkNYUSA
| |
Collapse
|
14
|
Piliuk K, Tomforde S. Artificial intelligence in emergency medicine. A systematic literature review. Int J Med Inform 2023; 180:105274. [PMID: 37944275 DOI: 10.1016/j.ijmedinf.2023.105274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/21/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
Motivation and objective: Emergency medicine is becoming a popular application area for artificial intelligence methods but remains less investigated than other healthcare branches. The need for time-sensitive decision-making on the basis of high data volumes makes the use of quantitative technologies inevitable. However, the specifics of healthcare regulations impose strict requirements for such applications. Published contributions cover separate parts of emergency medicine and use disparate data and algorithms. This study aims to systematize the relevant contributions, investigate the main obstacles to artificial intelligence applications in emergency medicine, and propose directions for further studies. METHODS The contributions selection process was conducted with systematic electronic databases querying and filtering with respect to established exclusion criteria. Among the 380 papers gathered from IEEE Xplore, ACM Digital Library, Springer Library, ScienceDirect, and Nature databases 116 were considered to be a part of the survey. The main features of the selected papers are the focus on emergency medicine and the use of machine learning or deep learning algorithms. FINDINGS AND DISCUSSION The selected papers were classified into two branches: diagnostics-specific and triage-specific. The former ones are focused on either diagnosis prediction or decision support. The latter covers such applications as mortality, outcome, admission prediction, condition severity estimation, and urgent care prediction. The observed contributions are highly specialized within a single disease or medical operation and often use privately collected retrospective data, making them incomparable. These and other issues can be addressed by creating an end-to-end solution based on human-machine interaction. CONCLUSION Artificial intelligence applications are finding their place in emergency medicine, while most of the corresponding studies remain isolated and lack higher generalization and more sophisticated methodology, which can be a matter of forthcoming improvements.
Collapse
Affiliation(s)
| | - Sven Tomforde
- Christian-Albrechts-Universität zu Kiel, 24118 Kiel, Germany
| |
Collapse
|
15
|
Scholz SS, Thies KC. Automated external defibrillator drones and their role in emergency response. Lancet Digit Health 2023; 5:e849-e850. [PMID: 38000868 DOI: 10.1016/s2589-7500(23)00217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/16/2023] [Indexed: 11/26/2023]
Affiliation(s)
- Sean S Scholz
- Department of Anaesthesiology and Critical Care, EvKB University Hospital Bielefeld, 33617 Bielefeld, Germany
| | - Karl-Christian Thies
- Department of Anaesthesiology and Critical Care, EvKB University Hospital Bielefeld, 33617 Bielefeld, Germany.
| |
Collapse
|
16
|
Abstract
Introduction Millions of out-of-hospital cardiac arrests (OHCA) occur globally each year. Survival after OHCA can be improved with the use of automated external defibrillators (AED). The main strategy for facilitating bystander defibrillation has been fixed-location public access defibrillators (PADs). New strategies of mobile AEDs depart from the model of static PADs and have the potential to address known barriers to early defibrillation and improve outcomes. Methods Mobile AEDs was one of six focus topics for the Wolf Creek XVII Conference held on June 14-17, 2023, in Ann Arbor, Michigan, USA. Conference invitees included international thought leaders and scientists in the field of cardiac arrest resuscitation from academia and industry. Participants submitted via online survey knowledge gaps, barriers to translation and research priorities for each focus topic. Expert panels used the survey results and their own perspectives and insights to create and present a preliminary unranked list for each category that was debated, revised, and ranked by all attendees to identify the top 5 for each category. Results Top knowledge gaps center around understanding the impact of mobile AEDs on OHCA outcomes in various settings and the impact of novel AED technologies. Top barriers to translation include questionable public comfort/acceptance, financial/regulatory constraints, and a lack of centralized accountability. Top research priorities focus on understanding the impact of the mobile AED strategies and technologies on time to defibrillation and OHCA outcomes. Conclusion This work informs research agendas, funding priorities and policy decisions around using mobile AEDs to optimize prehospital response to OHCA.
Collapse
Affiliation(s)
- Christine M. Brent
- Department of Emergency Medicine, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Sheldon Cheskes
- Sunnybrook Center for Prehospital Medicine, Regions of Halton and Peel, 77 Browns Line, Suite 100, Toronto, Ontario M8W 3S2, Canada
- Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada
| | - Maaret Castrén
- Department of Emergency Medicine and Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- HUS Akuutti, PL 340, 00029 HUS Meilahden tornisairaala, Haartmaninkatu 4, Finland
| | - Steven C. Brooks
- Department of Emergency Medicine, Queen’s University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada
| |
Collapse
|
17
|
Kovoor JG, Bacchi S, Gupta AK, Stretton B, Page GJ, Kovoor P. Refining Automated External Defibrillator Signage to Improve Out-of-Hospital Cardiac Arrest Survival. Heart Lung Circ 2023; 32:e51-e52. [PMID: 37673552 DOI: 10.1016/j.hlc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/06/2023] [Accepted: 03/21/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Joshua G Kovoor
- University of Adelaide, Adelaide, SA, Australia; Queen Elizabeth Hospital, Adelaide, SA, Australia; Heart of the Nation, Sydney, NSW, Australia; Health and Information, Adelaide, SA, Australia; Royal Adelaide Hospital, Adelaide, SA, Australia. http://www.twitter.com/josh.kovoor
| | - Stephen Bacchi
- Health and Information, Adelaide, SA, Australia; Royal Adelaide Hospital, Adelaide, SA, Australia; Flinders University, Flinders Medical Centre, Adelaide, SA, Australia
| | - Aashray K Gupta
- University of Adelaide, Adelaide, SA, Australia; Health and Information, Adelaide, SA, Australia; Gold Coast University Hospital, Gold Coast, Qld, Australia
| | - Brandon Stretton
- University of Adelaide, Adelaide, SA, Australia; Queen Elizabeth Hospital, Adelaide, SA, Australia; Health and Information, Adelaide, SA, Australia; Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Gregory J Page
- Heart of the Nation, Sydney, NSW, Australia. http://www.twitter.com/GregPage_Yellow
| | - Pramesh Kovoor
- Heart of the Nation, Sydney, NSW, Australia; Health and Information, Adelaide, SA, Australia; University of Sydney, Westmead Hospital, Sydney, NSW, Australia.
| |
Collapse
|
18
|
Fischer P, Rohrer U, Nürnberger P, Manninger M, Scherr D, von Lewinski D, Zirlik A, Wankmüller C, Kolesnik E. Automated external defibrillator delivery by drone in mountainous regions to support basic life support - A simulation study. Resusc Plus 2023; 14:100384. [PMID: 37091925 PMCID: PMC10120372 DOI: 10.1016/j.resplu.2023.100384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background Out-of-hospital cardiac arrest (OHCA) is associated with poor survival rates. Factors that may enable survival include cardiopulmonary resuscitation (CPR) initiated by bystanders and early use of an automated external defibrillator (AED). This explorative simulation study was conceptualized to test the feasibility of a semi-autonomously operating drone that delivers an AED to a remote emergency location and its bystander-use. Methods Ten paramedics and nineteen laypersons were confronted with a manikin simulating an OHCA as single bystanders within a field test located in a mountainous region between Austria and Slovenia. The scenario included a mock-call to the local emergency response center that dispatched a drone towards the caller's GPS coordinates and supported the ongoing CPR. The outcomes were the successful delivery of the AED, the time to the first shock, hands-off times, and the overall performance of the CPR. Results The AED was delivered by drone and used in all 29 scenarios without serious adverse events. The flight time of the drone was in median 5:20 (range: 1:35-8:19) minutes. The paramedics delivered the first shock after a mean of 12:15 ± 2:03 min and hands-off times were 50 ± 22 s. The laypersons delivered the first shock after 14:04 ± 2:10 min and hands-off times were 2:11 ± 0:39 min. All participants felt confident in the handling of the delivered AED. Conclusion The delivery and usage of an AED via a semi-autonomously flying drone in a remote region is feasible. This approach can lead to early administration of shocks.
Collapse
Affiliation(s)
- Philip Fischer
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Ursula Rohrer
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Corresponding author.
| | - Patrick Nürnberger
- Austrian Red Cross, Landesverband Kärnten, Grete-Bittner-Straße 9, 9020 Klagenfurt am Wörthersee, Austria
| | - Martin Manninger
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Daniel Scherr
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Dirk von Lewinski
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Andreas Zirlik
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Christian Wankmüller
- Austrian Red Cross, Landesverband Kärnten, Grete-Bittner-Straße 9, 9020 Klagenfurt am Wörthersee, Austria
- Department of Operations, Energy, and Environmental Management, University of Klagenfurt, Universitätsstraße 65-67, 9020 Klagenfurt am Wörthersee, Austria
| | - Ewald Kolesnik
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
- Austrian Red Cross, Landesverband Kärnten, Grete-Bittner-Straße 9, 9020 Klagenfurt am Wörthersee, Austria
| |
Collapse
|
19
|
Benis A, Haghi M, Deserno TM, Tamburis O. One Digital Health Intervention for Monitoring Human and Animal Welfare in Smart Cities: Viewpoint and Use Case. JMIR Med Inform 2023; 11:e43871. [PMID: 36305540 DOI: 10.2196/43871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/15/2023] [Accepted: 04/18/2023] [Indexed: 05/20/2023] Open
Abstract
Smart cities and digital public health are closely related. Managing digital transformation in urbanization and living spaces is challenging. It is critical to prioritize the emotional and physical health and well-being of humans and their animals in the dynamic and ever-changing environment they share. Human-animal bonds are continuous as they live together or share urban spaces and have a mutual impact on each other's health as well as the surrounding environment. In addition, sensors embedded in the Internet of Things are everywhere in smart cities. They monitor events and provide appropriate responses. In this regard, accident and emergency informatics (A&EI) offers tools to identify and manage overtime hazards and disruptive events. Such manifold focuses fit with One Digital Health (ODH), which aims to transform health ecosystems with digital technology by proposing a comprehensive framework to manage data and support health-oriented policies. We showed and discussed how, by developing the concept of ODH intervention, the ODH framework can support the comprehensive monitoring and analysis of daily life events of humans and animals in technologically integrated environments such as smart homes and smart cities. We developed an ODH intervention use case in which A&EI mechanisms run in the background. The ODH framework structures the related data collection and analysis to enhance the understanding of human, animal, and environment interactions and associated outcomes. The use case looks at the daily journey of Tracy, a healthy woman aged 27 years, and her dog Mego. Using medical Internet of Things, their activities are continuously monitored and analyzed to prevent or manage any kind of health-related abnormality. We reported and commented on an ODH intervention as an example of a real-life ODH implementation. We gave the reader examples of a "how-to" analysis of Tracy and Mego's daily life activities as part of a timely implementation of the ODH framework. For each activity, relationships to the ODH dimensions were scored, and relevant technical fields were evaluated in light of the Findable, Accessible, Interoperable, and Reusable principles. This "how-to" can be used as a template for further analyses. An ODH intervention is based on Findable, Accessible, Interoperable, and Reusable data and real-time processing for global health monitoring, emergency management, and research. The data should be collected and analyzed continuously in a spatial-temporal domain to detect changes in behavior, trends, and emergencies. The information periodically gathered should serve human, animal, and environmental health interventions by providing professionals and caregivers with inputs and "how-to's" to improve health, welfare, and risk prevention at the individual and population levels. Thus, ODH complementarily combined with A&EI is meant to enhance policies and systems and modernize emergency management.
Collapse
Affiliation(s)
- Arriel Benis
- Department of Digital Medical Technologies, Holon Institute of Technology, Holon, Israel
- Working Group "One Digital Health", European Federation for Medical Informatics (EFMI), Le Mont-sur-Lausanne, Switzerland
- Working Group "One Digital Health", International Medical Informatics Association (IMIA), Chene-Bourg, Geneva, Switzerland
| | - Mostafa Haghi
- Ubiquitous Computing Laboratory, Department of Computer Science, HTWG Konstanz - University of Applied Sciences, Konstanz, Germany
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
- Working Group "Accident & Emergency Informatics", International Medical Informatics Association (IMIA), Chene-Bourg, Geneva, Switzerland
| | - Thomas M Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
- Working Group "Accident & Emergency Informatics", International Medical Informatics Association (IMIA), Chene-Bourg, Geneva, Switzerland
| | - Oscar Tamburis
- Working Group "One Digital Health", European Federation for Medical Informatics (EFMI), Le Mont-sur-Lausanne, Switzerland
- Working Group "One Digital Health", International Medical Informatics Association (IMIA), Chene-Bourg, Geneva, Switzerland
- Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy
| |
Collapse
|
20
|
Gino B, Siraj S, Peixoto M, Benson A, Dubrowski A. Comparing Learning Outcomes in Cardiopulmonary Resuscitation (CPR) and/or Automated External Defibrillator (AED) Training for Laypeople in Face-to-Face, Online, and Mixed Training Methods: An Integrative Literature Review. Cureus 2023; 15:e38489. [PMID: 37273311 PMCID: PMC10237343 DOI: 10.7759/cureus.38489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Cardiovascular diseases and cardiac arrest (CA) are the main causes of death worldwide. This review aims to identify publications on the learning outcomes for the use of an automated external defibrillator (AED) and/or cardiopulmonary resuscitation (CPR) to train laypeople (LP), the method of training used, the year of publication and their recommendations. We employed Miller's assessment pyramid to describe learning outcomes as knowledge, skills, and confidence. The methods of training are face-to-face, online, and mixed. The evidence found in this study will be used to support the development and validation of a simulation-based training program to teach LP to operate AEDs delivered by drones in rural and remote (R&R) locations. This article is an integrative literature review with a quantitative and qualitative research design and is composed of seven steps: research question, inclusion and exclusion criteria, search and selection of studies, the role of a second reviewer of the findings, data analysis, interpretation and discussion of the results, and finally knowledge synthesis. The results of this review demonstrate that there are no significant differences in the learning outcomes of the different training methods. Since these findings suggest good results in all methods, the development of a training program based on face-to-face, online, and mixed, especially for places with few resources such as R&R places, indicates all methods can be used as good practices to develop training programs.
Collapse
Affiliation(s)
- Bruno Gino
- Emergency Medicine, Memorial University of Newfoundland, St. John's, CAN
- Health Sciences, Ontario Tech University, Oshawa, CAN
| | - Samyah Siraj
- Health Sciences, Ontario Tech University, Oshawa, CAN
| | - Maria Peixoto
- Computer Engineering, Ontario Tech University, Oshawa, CAN
| | - Andy Benson
- Central East Prehospital Care Program (CEPCP), Lakeridge Health Hospital, Oshawa, CAN
| | | |
Collapse
|
21
|
van Veelen MJ, Roveri G, Voegele A, Cappello TD, Masè M, Falla M, Regli IB, Mejia-Aguilar A, Mayrgündter S, Strapazzon G. Drones reduce the treatment-free interval in search and rescue operations with telemedical support - A randomized controlled trial. Am J Emerg Med 2023; 66:40-44. [PMID: 36680868 DOI: 10.1016/j.ajem.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Response to medical incidents in mountainous areas is delayed due to the remote and challenging terrain. Drones could assist in a quicker search for patients and can facilitate earlier treatment through delivery of medical equipment. We aim to assess the effects of using drones in search and rescue (SAR) operations in challenging terrain. We hypothesize that drones can reduce the search time and treatment-free interval of patients by delivering an emergency kit and telemedical support. METHODS In this randomized controlled trial with a cross-over design two methods of searching for and initiating treatment of a patient were compared. The primary outcome was a comparison of the times for locating a patient through visual contact and starting treatment on-site between the drone-assisted intervention arm and the conventional ground-rescue control arm. A linear mixed model (LMM) was used to evaluate the effect of using a drone on search and start of treatment times. RESULTS Twenty-four SAR missions, performed by six SAR teams each with four team members, were analyzed. The mean time to locate the patient was 14.6 min (95% CI 11.3-17.9) in the drone-assisted intervention arm and 20.6 min (95% CI 17.3-23.9) in the control arm. The mean time to start treatment was 15.7 min (95% CI 12.4-19.0) in the drone-assisted arm and 22.4 min (95% CI 19.1-25.7) in the control arm (p < 0.01 for both comparisons). CONCLUSION The successful use of drones in SAR operations leads to a reduction in search time and treatment-free interval of patients in challenging terrain, which could improve outcomes in patients suffering from traumatic injuries, the most commonly occurring incident requiring mountain rescue operations.
Collapse
Affiliation(s)
- Michiel Jan van Veelen
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Department of Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria
| | - Giulia Roveri
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Anna Voegele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Tomas Dal Cappello
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Michela Masè
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Marika Falla
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy; Department of Neurology/Stroke Unit, General Hospital of Bolzano, Italy
| | - Ivo Beat Regli
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Department of Internal and Emergency Medicine, Buergerspital, Solothurn, Switzerland
| | | | - Sebastian Mayrgündter
- NOI Techpark, Bolzano, Italy; Corpo Nazionale Soccorso Alpino e Speleologico - CNSAS, Milano, Italy
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy; Corpo Nazionale Soccorso Alpino e Speleologico - CNSAS, Milano, Italy.
| |
Collapse
|
22
|
LeSueur MC, Rozanski EA, Karlin ET, LaMastro J, Rush JE. Evaluation of automated external defibrillator designed for people in dogs. J Vet Emerg Crit Care (San Antonio) 2023; 33:173-179. [PMID: 36815755 DOI: 10.1111/vec.13285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/04/2022] [Accepted: 03/17/2022] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To determine if human automated external defibrillators (AEDs) could successfully record cardiac electrical activity in dogs, make appropriate recommendations regarding shock delivery, and characterize skin preparation required for a readable ECG based on dog haircoat characteristics. DESIGN Prospective study of AED use in dogs conducted between January and March 2021. SETTING University teaching hospital. ANIMALS Three groups of client-owned dogs were evaluated. Group 1 consisted of 23 healthy dogs with sinus rhythms, group 2 consisted of 9 dogs with documented cardiac arrhythmias, and group 3 consisted of 9 dogs receiving CPR following naturally occurring cardiopulmonary arrest. MATERIALS AND METHODS Haircoat characteristics and clipping or ECG paste required to obtain a readable ECG were recorded. The time interval from a readable ECG by the investigator until AED shock advisement was measured. Correctness of shock advice was recorded. Analyses were performed using commercial statistical software. P-values <0.05 were considered significant. RESULTS The attending veterinarian judged the ECG on the AED to be readable in all dogs. Time to shock advisement in all dogs was median 18 (range: 7-180) seconds. Dogs with heavy, long, or double haircoats required clipping in 24 of 27 (89%) cases to obtain a readable ECG. ECG paste on the AED pad was required in 36 of 40 dogs (90%) in order to obtain a readable ECG. The AED advice for delivery of shock was appropriate in 51 of 52 (98%) queries of the machine across all groups. CONCLUSIONS Human AEDs can successfully record cardiac electrical activity in dogs. AEDs appropriately recommend delivery of a shock most times, contingent on skin preparation. Dogs with double, long, or heavy haircoats should be clipped prior to pad application. ECG paste will aid AED reading in all haircoat types. Further investigation is warranted into AED use in dogs, particularly in general practices.
Collapse
Affiliation(s)
- Meriel C LeSueur
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Emily T Karlin
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Joey LaMastro
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - John E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| |
Collapse
|
23
|
Roberts NB, Ager E, Leith T, Lott I, Mason-Maready M, Nix T, Gottula A, Hunt N, Brent C. Current summary of the evidence in drone-based emergency medical services care. Resusc Plus 2023; 13:100347. [PMID: 36654723 PMCID: PMC9841214 DOI: 10.1016/j.resplu.2022.100347] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Interventions for many medical emergencies including cardiac arrests, strokes, drug overdoses, seizures, and trauma, are critically time-dependent, with faster intervention leading to improved patient outcomes. Consequently, a major focus of emergency medical services (EMS) systems and prehospital medicine has been improving the time until medical intervention in these time-sensitive emergencies, often by reducing the time required to deliver critical medical supplies to the scene of the emergency. Medical indications for using unmanned aerial vehicles, or drones, are rapidly expanding, including the delivery of time-sensitive medical supplies. To date, the drone-based delivery of a variety of time-critical medical supplies has been evaluated, generating promising data suggesting that drones can improve the time interval to intervention through the rapid delivery of automatic external defibrillators (AEDs), naloxone, antiepileptics, and blood products. Furthermore, the improvement in the time until intervention offered by drones in out-of-hospital emergencies is likely to improve patient outcomes in time-dependent medical emergencies. However, barriers and knowledge gaps remain that must be addressed. Further research demonstrating functionality in real-world scenarios, as well as research that integrates drones into the existing EMS structure will be necessary before drones can reach their full potential. The primary aim of this review is to summarize the current evidence in drone-based Emergency Medical Services Care to help identify future research directions.
Collapse
Affiliation(s)
- Nathan B. Roberts
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
| | - Emily Ager
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
| | - Thomas Leith
- University of Michigan Medical School, 7300 Medical Science Building I—A Wing, 1301 Catherine St, Ann Arbor, MI 48109, USA
| | - Isabel Lott
- University of Michigan Medical School, 7300 Medical Science Building I—A Wing, 1301 Catherine St, Ann Arbor, MI 48109, USA
| | - Marlee Mason-Maready
- Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309, USA
| | - Tyler Nix
- University of Michigan, Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI 48109, USA
| | - Adam Gottula
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- The University of Michigan, Department of Anesthesiology , University of Michigan Medical School, 1500 East Medical Center Dr. Ann Arbor, MI 48109, USA
| | - Nathaniel Hunt
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
| | - Christine Brent
- University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA
- Corresponding authors at: Medical School, University of Michigan Department of Emergency Medicine, University of Michigan Medical School, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5305, USA.
| |
Collapse
|
24
|
Fink F, Paulicke D, Grünthal M, Jahn P. "Of course, drones delivering urgent medicines are necessary. But I would not use them until…" Insights from a qualitative study on users' needs and requirements regarding the use of medical drones. PLoS One 2023; 18:e0285393. [PMID: 37155650 PMCID: PMC10166545 DOI: 10.1371/journal.pone.0285393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 04/13/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND The current COVID-19 pandemic, demographic trends, and the increasing shortage of skilled workers pose major challenges for the care of people with and without care needs. The potential of drones as unmanned aerial vehicles in health care is being discussed as an effective innovative way of delivering much-needed medicines, especially in rural areas. Although the advantages are well known, the needs of the users have not yet been taken into account. METHODS Online-based focus groups (via WebEx) were conducted with participants from different disciplines: nursing, pharmacy, physicians. Focus groups with COVID-19 patients were conducted face-to-face. The focus was primarily on potential problems and requirements of the users regarding the use of drones. Structured and contrastive snowball sampling has been deployed. The focus groups were audio recorded, transcribed by a transcription-company, and coded with the help of the program "f4analyse 2" for content (Elo et al. 2008). RESULTS Especially during the pandemic situation, delays, and restrictions in the delivery of medicines have been noticed. All interview partners (patients, pharmacists, physicians, and nurses; n = 36 participants) see drones as useful in cases of limited mobility, time-critical medicines (rapid availability), emergencies, and disasters (e.g., floods), but also for the delivery of regular medicines in rural areas (e.g., for the treatment of chronic diseases). Moreover, only 16.7% of the participants have experiences with drones. DISCUSSION Drone deliveries do not play a role in the health system yet despite their great importance, which is perceived as particularly evident in the pandemic situation. The results lead to the conclusion that this is mainly due to knowledge and application deficits, so that educational and advisory work is absolutely necessary. There is also a need for further studies that go beyond the scope of acceptance research to describing and evaluating concrete scenarios of drone delivery on the basis of a user-centered approach.
Collapse
Affiliation(s)
- Franziska Fink
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Translationsregion für digitalisierte Gesundheitsversorgung (TDG), Halle (Saale), Germany
| | - Denny Paulicke
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Akkon University of Human Sciences, Department of Medical Pedagogy, Berlin, Germany
| | | | - Patrick Jahn
- Health Service Research Working Group, Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Translationsregion für digitalisierte Gesundheitsversorgung (TDG), Halle (Saale), Germany
| |
Collapse
|
25
|
Drones delivering automated external defibrillators: A new strategy to improve the prognosis of out-of-hospital cardiac arrest. Resuscitation 2023; 182:109669. [PMID: 36535307 DOI: 10.1016/j.resuscitation.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a serious threat to human life and health, characterized by high morbidity and mortality. However, given the limitations of the current emergency medical system (EMS), it is difficult to immediately treat patients who experience OHCA. It is well known that rapid defibrillation after cardiac arrest is essential for improving the survival rate of OHCA, yet automated external defibrillators (AED) are difficult to obtain in a timely manner. OBJECTIVE This review illustrates the feasibility and advantages of AED delivery by drones by surveying current studies on drones, explains that drones are a new strategy in OHCA, and finally proposes novel strategies to address existing problems with drone systems. RESULTS The continuous development of drone technology has been beneficial for patients who experience OHCA, as drones have demonstrated powerful capabilities to provide rapid delivery of AED. Drones have great advantages over traditional EMS, and the delivery of AED by drones for patients with OHCA is a new strategy. However, the application of this new strategy in real life still has many challenges. CONCLUSION Drones are promising and innovative tools. Many studies have demonstrated that AED delivery by drones is feasible and cost-effective; however, as a new strategy to improve the survival rate of OHCA patients, there remain problems to be solved. In the future, more in-depth investigations need to be conducted.
Collapse
|
26
|
Thies KC, Jansen G, Wähnert D. [AED drones on the rise? : Use of drones to improve public access defibrillation]. DIE ANAESTHESIOLOGIE 2022; 71:865-871. [PMID: 36166065 PMCID: PMC9636099 DOI: 10.1007/s00101-022-01204-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The poor availability of automatic external defibrillators (AED) and the modest knowledge of lay persons in handling these devices has led to an insufficient spread of public access defibrillation in Germany. OBJECTIVE This article examines whether the automated deployment of AED drones to out-of-hospital cardiac arrest can help to remedy this situation. METHODS Narrative literature review, evaluation of statistics, analysis of relevant media reports, and discussion of key research. RESULTS The present investigations are mainly located in the experimental field and demonstrate the feasibility and safety of drone use, as well as shorter times to first defibrillation, which is confirmed by initial clinical studies. Mathematical models also indicate cost-effectiveness of airborne AED delivery compared to ground dispatch. Integration into the chain of survival appears to be possible but adaptations to existing emergency medical service structures and close cooperation with regional first responder and AED schemes as well as local authorities is required to optimise patient benefit and efficiency. CONCLUSION The use of AED drones could probably contribute to improving public access defibrillation in Germany. This applies to both rural and urban regions. The technological requirements are met but flight regulations still have to be amended. In order to explore the full potential of this novel technology, further field trials are required to achieve smooth integration into existing emergency medical services.
Collapse
Affiliation(s)
- Karl-Christian Thies
- Universitätsklinik für Anästhesiologie, Intensiv‑, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617 Bielefeld, Deutschland
| | - Gerrit Jansen
- Universitätsklinik für Anästhesiologie, Intensiv‑, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617 Bielefeld, Deutschland
| | - Dirk Wähnert
- Klinik für Unfallchirurgie und Orthopädie, Evangelisches Klinikum Bethel gGmbH, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617 Bielefeld, Deutschland
| |
Collapse
|
27
|
Król-Całkowska EJ, Walczak D. The Use of Drones in the Area of Minimizing Health Risk during the COVID-19 Epidemic. J INTELL ROBOT SYST 2022; 106:40. [PMID: 36196365 PMCID: PMC9523649 DOI: 10.1007/s10846-022-01729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Abstract
Despite their general availability, drones are not currently widely used in emergency medicine, distribution of medication and other medical products, as well as in epidemiological emergencies, in which limiting interpersonal contact is crucial for minimizing the public health risk. Given the current epidemiological situation, it is pertinent to consider, whether implementing activities with the use of drones can significantly contribute to minimizing health risks, and whether such initiatives are acceptable in the light of applicable legal regulations. The main objective is supported by an analysis of the usefulness of applicable provisions, indicating the direction of possible changes in existing legal regulations. Additionally, the article aims to demonstrate the feasibility of drone use in activities related to combating epidemics, as well as to emphasize their practical importance. Reports on the commercial use of drones in the distribution of goods and services have also been used as material for comprehensive analysis. Simultaneously, the article also includes data on quantities of equipment available to healthcare units in Poland for saving life and health. The present work uses the method of analysis of applicable legal regulations, as a criterion for the usefulness of existing solutions in the area of improving the quality of medical services, including preventive measures and combating the effects of an epidemic.
Collapse
|
28
|
Kotlinski M, Calkowska JK. U-Space and UTM Deployment as an Opportunity for More Complex UAV Operations Including UAV Medical Transport. J INTELL ROBOT SYST 2022; 106:12. [PMID: 36039343 PMCID: PMC9400555 DOI: 10.1007/s10846-022-01681-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/28/2022] [Indexed: 11/02/2022]
Abstract
Unmanned Aerial Vehicles (UAVs) or Unmanned Aircraft Systems (UASs) commonly called drones are relatively new entrants to the airspace. The regulatory agencies, numerous States and entities are involved in creation of the safe integration with manned aviation. The so-called U-space concept announced by the European Commission is one of the approaches to achieve that goal. There is also known concept of Unmanned Traffic Management (UTM) – a tool which would enable the services needed for safe conduct of UAV flights in generally accessible airspace. There are quite a few European projects which focuses on testing UTM capabilities in order to find a solution which could enable the market and ensure safe UAV operations. One of those systems is PansaUTM – which was developed in order to coordinate drone flights in different types of airspace in Poland. The first part of the paper will present an example of the implementation of this system as a foundation for new possible applications of drones and increasing number of operations. The conclusion of the first part of the article is that, in line rapid growth of UAS flights and different applications of drone services, the European drone ecosystem should evolve even further to deploy very complex drone operations in scalable manner. In order to accommodate unmanned air taxi operations, cargo flights, medical cargo flights, automatic surveillance flights, etc. Europe is preparing towards deployment of Advanced Air Mobility (AAM). The second part of the text indicate the possibility of extensive use of drones in medical logistics as well as minimizing the epidemiological risk as a result of the use of this mean of transport. At the same time, it should be stressed out that the medical transport using drones can be used in urgent situations, where the main variable that has an impact on the success of life and health saving is the breaking of barriers to reaching difficult-to-reach places. In addition, the development of transport using drones can have a lasting impact on improving the quality of life of chronically ill patients who experience severe disease recurrence and thus on the need to implement emergency prevention or treatment measures. The second part of the article focuses as well on the U-space concept as an opportunity for UAVs to be widely used in the field of day-to-day supplies as well as health-related supplies. In the context of the spread of SARS-CoV-2 virus, drones may be used to provide diagnostic screening tests, medicinal products and septic materials, transport of samples of biological material, as well as an information campaign on how to deal with an epidemic, quarantine or isolation at home. The use of UAV for medical supplies is economically and legally justified. The U-space environment from the operational and regulatory side is a multidisciplinary approach that requires the interaction of aviation, law, medicine, robotics, mechatronics and engineering experts. The legal framework for the development of U-space should be taken into account, as well as sector-specific regulations taking into account the principles of the use of drones in strictly defined areas, including in the process of medical supply, and liability for damage caused by UAV medical supply or AI-controlled intelligent machines.
Collapse
|
29
|
Robakowska M, Ślęzak D, Żuratyński P, Tyrańska-Fobke A, Robakowski P, Prędkiewicz P, Zorena K. Possibilities of Using UAVs in Pre-Hospital Security for Medical Emergencies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10754. [PMID: 36078469 PMCID: PMC9518096 DOI: 10.3390/ijerph191710754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
The term unmanned aerial vehicle (UAV) was post-applied in the 1980s to describe remotely piloted multi-purpose, unmanned, autonomous aircraft. The terms unmanned aircraft systems with data terminal connectivity (UAS) and remotely piloted aircraft systems (RPV, RPAS-military systems) are also used. This review aims to analyze the feasibility of using UAVs to support emergency medical systems in the supply and urgent care ranges. The implementation of drones in the medical security system requires proper planning of service cooperation, division of the area into sectors, assessment of potential risks and opportunities, and legal framework for the application. A systematic literature search was conducted to assess the applicability based on published scientific papers on possible medical drone applications in the field of urgent mode. The widespread applications of UAVs in healthcare are concerned with logistics, scope, and transportability, with framework legal constraints to effectively exploit opportunities for improving population health, particularly for costly critical situations.
Collapse
Affiliation(s)
- Marlena Robakowska
- Department of Public Health & Social Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
| | - Daniel Ślęzak
- Division of Medical Rescue, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
| | - Przemysław Żuratyński
- Division of Medical Rescue, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
- Department of Anesthesiology and Intensive Care, Oncology Center—Memorial Hospital in Bydgoszcz, 85-796 Bydgoszcz, Poland
| | - Anna Tyrańska-Fobke
- Department of Public Health & Social Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
| | - Piotr Robakowski
- Division of Medical Rescue, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, 80-210 Gdansk, Poland
| | - Paweł Prędkiewicz
- Department of Finance, Faculty of Economics and Finance, Wrocław University of Economics, 53-345 Wroclaw, Poland
| | - Katarzyna Zorena
- Department of Immunobiology and Environmental Microbiology, Medical University of Gdansk, 80-211 Gdansk, Poland
| |
Collapse
|
30
|
Abstract
Introduction: In recent years, the use of drones in health emergencies has increased. Among their main benefits are avoiding endangering rescuers, travelling long distances in a short time, or contacting victims in risky situations; but despite their multiple advantages, their use has not been fully demonstrated. Study Objective: This study aims to identify the available evidence on the use of drones in emergency health care compared to traditional health care. Methods: Systematic review of the literature was conducted. Search protocols were developed to locate studies that met the established selection criteria. Six experimental or quasi-experimental studies with high methodological quality published from the beginning of indexing until 2020 were included. Results: Drones covered a significantly larger area than other traditional tracking methods and were very useful for performing preliminary triage, determining needs, and knowing the scene prior to the arrival of rescuers. In addition, drones reduced the time required to locate the victim. Conclusions: Drones are an element to be taken into account when attending health emergencies as they significantly improve the distance travelled to locate accident victims, have the possibility of performing triage prior to the arrival of the health care units, and improve the time and quality of the care provided.
Collapse
|
31
|
Comtet HE, Keitsch M, Johannessen KA. Realities of Using Drones to Transport Laboratory Samples: Insights from Attended Routes in a Mixed-Methods Study. J Multidiscip Healthc 2022; 15:1871-1885. [PMID: 36068877 PMCID: PMC9441146 DOI: 10.2147/jmdh.s371957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hans E Comtet
- The Intervention Centre, Oslo University Hospital, Oslo, 0424, Norway
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway
- Correspondence: Hans E Comtet, The Intervention Centre, Oslo University Hospital, Postboks 4950, Oslo, 0424, Norway, Email
| | - Martina Keitsch
- Department of Design, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway
| | - Karl-Arne Johannessen
- The Intervention Centre, Oslo University Hospital, Oslo, 0424, Norway
- Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, 0318, Norway
| |
Collapse
|
32
|
Abstract
PURPOSE OF REVIEW Technology is being increasingly implemented in the fields of cardiac arrest and cardiopulmonary resuscitation. In this review, we describe how recent technological advances have been implemented in the chain of survival and their impact on outcomes after cardiac arrest. Breakthrough technologies that are likely to make an impact in the future are also presented. RECENT FINDINGS Technology is present in every link of the chain of survival, from prediction, prevention, and rapid recognition of cardiac arrest to early cardiopulmonary resuscitation and defibrillation. Mobile phone systems to notify citizen first responders of nearby out-of-hospital cardiac arrest have been implemented in numerous countries with improvement in bystanders' interventions and outcomes. Drones delivering automated external defibrillators and artificial intelligence to support the dispatcher in recognising cardiac arrest are already being used in real-life out-of-hospital cardiac arrest. Wearables, smart speakers, surveillance cameras, and artificial intelligence technologies are being developed and studied to prevent and recognize out-of-hospital and in-hospital cardiac arrest. SUMMARY This review highlights the importance of technology applied to every single step of the chain of survival to improve outcomes in cardiac arrest. Further research is needed to understand the best role of different technologies in the chain of survival and how these may ultimately improve outcomes.
Collapse
Affiliation(s)
- Tommaso Scquizzato
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan
| | - Lorenzo Gamberini
- Department of Anaesthesia and Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| | - Federico Semeraro
- Department of Anaesthesia and Intensive Care and EMS, Maggiore Hospital Bologna, Bologna, Italy
| |
Collapse
|
33
|
Stephan F, Reinsperger N, Grünthal M, Paulicke D, Jahn P. Human drone interaction in delivery of medical supplies: A scoping review of experimental studies. PLoS One 2022; 17:e0267664. [PMID: 35482656 PMCID: PMC9049298 DOI: 10.1371/journal.pone.0267664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic, ageing populations and the increasing shortage of skilled workers pose great challenges for the delivery of supplies for people with and without care needs. The potential of drones, as unmanned air vehicles, in healthcare are huge and are discussed as an effective new way to delivery urgent medicines and medical devices, especially in rural areas. Although the advantages are obvious, perspectives of users are important particularly in the development process. Investigating human drone interaction could potentially increase usefulness and usability. The present study aims to perform a systematic scoping review on experimental studies examining the human drone interaction in deliveries of drugs and defibrillators. Methods Two databases (MEDLINE and CINAHL) and references of identified publications were searched without narrowing the year of publication or language. Studies that investigated the human drone interaction or medical delivery with drones in an experimental manner were included (research articles). All studies that only simulated the delivery process were excluded. Results The search revealed 83 publications with four studies being included. These studies investigated the user experience of drone delivered defibrillators, but no study was identified that investigated the human drone interaction in the delivery of drugs. Three categories of human drone interaction were identified: landing, handover, and communications. Regarding landing and handover, the most important issue was the direct physical contact with the drone while regarding communications users need clearer instructions about drone´s direction, sound and look like. Discussion The identified studies used technology-driven approaches by investigating human drone interaction in already existing technologies. Users must become integral part of the whole development process of medical drone services to reduce concerns, and to improve security, usability and usefulness of the system. Human drone interaction should be developed according to the identified categories of human drone interaction by using demand- and technology-driven approaches.
Collapse
Affiliation(s)
- Franziska Stephan
- Health Service Research Working Group | Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Translationsregion Für Digitalisierte Gesundheitsversorgung (TDG), Halle (Saale), Germany
- * E-mail:
| | - Nicole Reinsperger
- Department of Internal Medicine, Health Service Research/Nursing in Hospital, University Hospital Halle (Saale), Halle (Saale), Germany
| | | | - Denny Paulicke
- Health Service Research Working Group | Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Akkon University of Human Sciences, Department of Medical Pedagogy, Berlin, Germany
| | - Patrick Jahn
- Health Service Research Working Group | Acute Care, Department of Internal Medicine, Faculty of Medicine, University Medicine Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
- Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Translationsregion Für Digitalisierte Gesundheitsversorgung (TDG), Halle (Saale), Germany
| |
Collapse
|
34
|
Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation. Circulation 2022; 145:e776-e801. [PMID: 35164535 DOI: 10.1161/cir.0000000000001013] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
Collapse
|
35
|
Brooks SC, Clegg GR, Bray J, Deakin CD, Perkins GD, Ringh M, Smith CM, Link MS, Merchant RM, Pezo-Morales J, Parr M, Morrison LJ, Wang TL, Koster RW, Ong MEH. Optimizing outcomes after out-of-hospital cardiac arrest with innovative approaches to public-access defibrillation: A scientific statement from the International Liaison Committee on Resuscitation. Resuscitation 2022; 172:204-228. [PMID: 35181376 DOI: 10.1016/j.resuscitation.2021.11.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Out-of-hospital cardiac arrest is a global public health issue experienced by ≈3.8 million people annually. Only 8% to 12% survive to hospital discharge. Early defibrillation of shockable rhythms is associated with improved survival, but ensuring timely access to defibrillators has been a significant challenge. To date, the development of public-access defibrillation programs, involving the deployment of automated external defibrillators into the public space, has been the main strategy to address this challenge. Public-access defibrillator programs have been associated with improved outcomes for out-of-hospital cardiac arrest; however, the devices are used in <3% of episodes of out-of-hospital cardiac arrest. This scientific statement was commissioned by the International Liaison Committee on Resuscitation with 3 objectives: (1) identify known barriers to public-access defibrillator use and early defibrillation, (2) discuss established and novel strategies to address those barriers, and (3) identify high-priority knowledge gaps for future research to address. The writing group undertook systematic searches of the literature to inform this statement. Innovative strategies were identified that relate to enhanced public outreach, behavior change approaches, optimization of static public-access defibrillator deployment and housing, evolved automated external defibrillator technology and functionality, improved integration of public-access defibrillation with existing emergency dispatch protocols, and exploration of novel automated external defibrillator delivery vectors. We provide evidence- and consensus-based policy suggestions to enhance public-access defibrillation and guidance for future research in this area.
Collapse
|
36
|
Gino B, Williams KL, Neilson CS, d'Entremont P, Dubrowski A, Renouf TS. The PHOENIX: Design and Development of a Three-Dimensional-Printed Drone Prototype and Corresponding Simulation Scenario Based on the Management of Cardiac Arrest. Cureus 2022; 14:e21594. [PMID: 35228952 PMCID: PMC8873274 DOI: 10.7759/cureus.21594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 11/08/2022] Open
Abstract
Sudden cardiac arrest (SCA) remains one of the most prevalent cardiovascular emergencies in the world. The development of international protocols and the use of accessible devices such as automated external defibrillators (AEDs) allowed for the standardization and organization of medical care related to SCA. When defibrillation is performed within five minutes of starting ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), the victim survival rate has increased considerably. Therefore, training healthcare professionals to use AEDs correctly is essential to improve patient outcomes and response time in the intervention. In this technical report, we advocate simulation-based education as a teaching methodology and an essential component of drone adaptation, novel technology, that can deliver AEDs to the site, as well as a training scenario to teach healthcare professionals how to operate the real-time communication components of drones and AEDs efficiently. Studies have suggested that simulation can be an effective way to train healthcare professionals. Through teaching methodology using simulation, training these audiences has the potential to reduce the response time to intervention, consequently, increasing the patient's chance of surviving.
Collapse
|
37
|
Smith CM. Defibrillation for out-of-hospital cardiac arrest. Year of the drone? Resuscitation 2022; 172:146-148. [PMID: 35090969 DOI: 10.1016/j.resuscitation.2022.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Christopher M Smith
- Warwick Clinical Trials Unit, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL.
| |
Collapse
|
38
|
Carolina Baumgarten M, Röper J, Hahnenkamp K, Thies KC. Drones Delivering Automated External Defibrillators-Integrating Unmanned Aerial Systems into the Chain of Survival: A Simulation Study in Rural Germany. Resuscitation 2021; 172:139-145. [PMID: 34971721 DOI: 10.1016/j.resuscitation.2021.12.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/04/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Community first responders (CFR) improve survival in out-of-hospital cardiac arrest (OHCA) but are often hampered by limited availability of public access defibrillation. Unmanned aerial systems (UAS) delivering automated external defibrillators (AED) directly to an OHCA site could help overcome this. We evaluated the feasibility of integrating UAS into the chain of survival in rural Northeast Germany. METHODS This simulation study explored UAS-AED delivery combined with a smartphone-based CFR dispatch. Five OHCA locations (A-E) were randomly selected. We routed a flight corridor to each of these sites from a corresponding UAS base; 50 OHCA scenarios with 10 flights per corridor were scheduled. All steps were accurately simulated, from a bystander finding the patient, making an emergency call, conducting dispatcher-assisted cardiopulmonary resuscitation, and simultaneous CFR plus UAS deployment, to the bystander and CFR interacting with UAS and AED. This process was time-tracked and video-recorded until defibrillation. RESULTS We performed 46 OHCA simulations. Missions were flown autonomously but needed pilot assistance during landing. Distances (km) and average time intervals from alert to defibrillation (td in min:sec±SD) were 0.4 (6:02±0:56), 2.29 (6:53±0:19), 4.0 (8:54±0:25), 7.43 (14:51±1:055), and 9.79 (15:51±1:16) for routes A to E, respectively. All participants were able to retrieve the AED within seconds after UAS landing and interacted safely with the UAS and AED. CONCLUSIONS Integrating airborne AED delivery into the chain of survival appeared feasible and safe but remains an experimental technology. Linking this with CFR potentially improves the availability of early public-access defibrillation, particularly in rural regions.
Collapse
Affiliation(s)
| | - Johann Röper
- Department of Anesthesiology, University Medicine Greifswald, Germany; University of Greifswald, Greifswald Germany
| | - Klaus Hahnenkamp
- Department of Anesthesiology, University Medicine Greifswald, Germany
| | - Karl-Christian Thies
- Department of Anesthesiology, Ev. Klinikum Bethel - Universitätsklinikum OWL der Universität Bielefeld, Germany
| |
Collapse
|
39
|
Allan KS, O'Neil E, Currie MM, Lin S, Sapp JL, Dorian P. Responding to Cardiac Arrest in the Community in the Digital Age. Can J Cardiol 2021; 38:491-501. [PMID: 34954009 DOI: 10.1016/j.cjca.2021.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 01/25/2023] Open
Abstract
Sudden cardiac arrest (SCA) is a common event, affecting almost 400,000 individuals annually in North America. Initiation of cardiopulmonary resuscitation (CPR) and early defibrillation using an automated external defibrillator (AED) are critical for survival, yet many bystanders are reluctant to intervene. Digital technologies, including mobile devices, social media and crowdsourcing may help play a role to improve survival from SCA. In this article we review the current digital tools and strategies available to increase rates of bystander recognition of SCA, prompt immediate activation of Emergency Medical Services (EMS), initiate high quality CPR and to locate, retrieve and operate AEDs. Smartphones can help to both educate and connect bystanders with EMS dispatchers, through text messaging or video-calling, to encourage the initiation of CPR and retrieval of the closest AED. Wearable devices and household smartspeakers could play a future role in continuous vital signs monitoring in individuals at-risk of lethal arrhythmias and send an alert to either chosen contacts or EMS. Machine learning algorithms and mathematical modeling may aid EMS dispatchers with better recognition of SCA as well as policymakers with where to best place AEDs for optimal accessibility. There are challenges with the use of digital tech, including the need for government regulation and issues with data ownership, accessibility and interoperability. Future research will include smart cities, e-linkages, new technologies and using social media for mass education. Together or in combination, these emerging digital technologies may represent the next leap forward in SCA survival.
Collapse
Affiliation(s)
- Katherine S Allan
- Division of Cardiology, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
| | - Emma O'Neil
- Department of Emergency Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada
| | - Margaret M Currie
- Faculty of Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Steve Lin
- Department of Emergency Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - John L Sapp
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Paul Dorian
- Division of Cardiology, Unity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
40
|
Johnson AM, Cunningham CJ, Arnold E, Rosamond WD, Zègre-Hemsey JK. Impact of Using Drones in Emergency Medicine: What Does the Future Hold? Open Access Emerg Med 2021; 13:487-498. [PMID: 34815722 PMCID: PMC8605877 DOI: 10.2147/oaem.s247020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/02/2021] [Indexed: 12/28/2022] Open
Abstract
The use of unmanned aerial vehicles or "drones" has expanded in the last decade, as their technology has become more sophisticated, and costs have decreased. They are now used routinely in farming, environmental surveillance, public safety, commercial product delivery, recreation, and other applications. Health-related applications are only recently becoming more widely explored and accepted. The use of drone technology in emergency medicine is especially promising given the need for a rapid response to enhance patient outcomes. The purpose of this paper is to describe some of the main current and expanding applications of drone technology in emergency medicine and to describe challenges and future opportunities. Current applications being studied include delivery of defibrillators in response to out-of-hospital cardiac arrest, blood and blood products in response to trauma, and rescue medications. Drones are also being studied and actively used in emergency response to search and rescue operations as well as disaster and mass casualty events. Current challenges to expanding their use in emergency medicine and emergency medical system (EMS) include regulation, safety, flying conditions, concerns about privacy, consent, and confidentiality, and details surrounding the development, operation, and maintenance of a medical drone network. Future research is needed to better understand end user perceptions and acceptance. Continued technical advances are needed to increase payload capacities, increase flying distances, and integrate drone networks into existing 9-1-1 and EMS systems. Drones are a promising technology for improving patient survival, outcomes, and quality of life, particularly for those in areas that are remote or that lack funds or infrastructure. Their cost savings compared with ground transportation alone, speed, and convenience make them particularly applicable in the field of emergency medicine. Research to date suggests that use of drones in emergency medicine is feasible, will be accepted by the public, is cost-effective, and has broad application.
Collapse
Affiliation(s)
- Anna M Johnson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Evan Arnold
- Institute for Transportation Research and Education, North Carolina State University, Raleigh, NC, USA
| | - Wayne D Rosamond
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | |
Collapse
|
41
|
Rees N, Howitt J, Breyley N, Geoghegan P, Powel C. A simulation study of drone delivery of Automated External Defibrillator (AED) in Out of Hospital Cardiac Arrest (OHCA) in the UK. PLoS One 2021; 16:e0259555. [PMID: 34780477 PMCID: PMC8592459 DOI: 10.1371/journal.pone.0259555] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Drones are increasingly used in healthcare, and feasibility studies of deployment of Automated External Defibrillators (AED) in Out-of-hospital cardiac arrest (OHCA) have been conducted. Despite the potential contribution of drones to healthcare, regulatory barriers exist, including limits on flights beyond visual line-of-sight (BVLOS). The aim of this project was to deliver an AED BVLOS in Wales. Methods We developed of a Concept of Operations (CONOPS) to identify requirements, constraints, organisation and roles and responsibilities associated with deploying a drone to deliver an AED BVLOS. We equipped a Penguin B drone with satellite-enabled technology to enhance situational awareness and safety for the remote pilot. A BVLOS Operating Safety Case and three-week flight test programme was conducted with an AED attached directly to parachute for deployment to simulated OHCA. Results We completed six flights totalling 92km, 1:02.5 hours of flight time and four successful parachute payload drops. We conducted a successful end-to-end flight demonstration of an AED delivered via BVLOS by drone to a simulated OHCA and resuscitation by lay responder’s in a remote location; the final delivery of 4.5km was completed in 2:50 minutes. Conclusion We have delivered an AED by parachute, from fixed wing drone BVLOS in the UK in simulated OHCA. This project adds to the body of knowledge required for regulatory assurance on drone use BVLOS. Further research is needed before routine use of this technology.
Collapse
Affiliation(s)
- Nigel Rees
- Welsh Ambulance Services NHS Trust (WAST): Pre Hospital Emergency Research Unit (PERU), Institute of Life Sciences Swansea University Singleton Park, Swansea, Wales, United Kingdom
- * E-mail:
| | | | - Nigel Breyley
- Cyclops Air Cyclops Air Ltd, Lincoln, United Kingdom
| | | | - Carl Powel
- Welsh Ambulance Services NHS Trust (WAST): Pre Hospital Emergency Research Unit (PERU), Institute of Life Sciences Swansea University Singleton Park, Swansea, Wales, United Kingdom
| |
Collapse
|
42
|
Tindale A, Valli H, Butt H, Beattie CJ, Adasuriya G, Warraich M, Ahmad M, Banerjee A, Providencia R, Haldar S. Different methods of providing automatic external defibrillators to out-of-hospital cardiac arrests to prevent sudden cardiac death. Hippokratia 2021. [DOI: 10.1002/14651858.cd014766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alexander Tindale
- Royal Brompton and Harefield NHS Foundation Trust; London UK
- Imperial College London; London UK
| | - Haseeb Valli
- Department of Cardiology; Homerton University Hospital; London UK
| | - Haroun Butt
- Royal Brompton and Harefield NHS Foundation Trust; London UK
| | | | | | - Mazhar Warraich
- Department of Internal Medicine; The Royal Wolverhampton Hospitals NHS Trust; Wolverhampton UK
| | - Mahmood Ahmad
- Department of Cardiology; Royal Free Hospital, Royal Free London NHS Foundation Trust; London UK
| | - Amitava Banerjee
- Institute of Health Informatics Research; University College London; London UK
| | - Rui Providencia
- Barts Heart Centre; St Bartholomew's Hospital, Barts Health NHS Trust; London UK
| | - Shouvik Haldar
- Royal Brompton and Harefield NHS Foundation Trust; London UK
- Imperial College London; London UK
| |
Collapse
|
43
|
Matinrad N, Reuter-Oppermann M. A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services. CENTRAL EUROPEAN JOURNAL OF OPERATIONS RESEARCH 2021; 30:251-302. [PMID: 34566490 PMCID: PMC8449697 DOI: 10.1007/s10100-021-00769-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 05/31/2023]
Abstract
Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage-creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic-as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.
Collapse
Affiliation(s)
- Niki Matinrad
- Department of Science and Technology, Linköping University, Norrköping, 60174 Sweden
| | - Melanie Reuter-Oppermann
- Information Systems - Software and Digital Business Group, Technical University of Darmstadt, 64289 Darmstadt, Germany
| |
Collapse
|
44
|
van Veelen MJ, Voegele A, Rauch S, Kaufmann M, Brugger H, Strapazzon G. COVID-19 Pandemic in Mountainous Areas: Impact, Mitigation Strategies, and New Technologies in Search and Rescue Operations. High Alt Med Biol 2021; 22:335-341. [PMID: 34319777 PMCID: PMC8558066 DOI: 10.1089/ham.2020.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/29/2021] [Indexed: 12/03/2022] Open
Abstract
van Veelen, Michiel J., Anna Voegele, Simon Rauch, Marc Kaufmann, Hermann Brugger, and Giacomo Strapazzon. COVID-19 pandemic in mountainous areas: impact, mitigation strategies, and new technologies in search and rescue operations. High Alt Med Biol. 22:335-341, 2021.-Mitigating the spread of COVID-19, an airborne infection, can lead to delays in the prehospital response and impair the performance of search and rescue (SAR) services in mountainous and remote areas. We provide an overview of the developing epidemiological situation related to the COVID-19 pandemic in mountainous areas and review current protocols to determine their suitability for mountain rescue teams. We also discuss using novel technologies to reduce the adverse effects caused by COVID-19 mitigation strategies such as delays caused by donning personal protective equipment (PPE) and reduced rescuer performance due to impaired movement and ventilation. COVID-19 has spread even in mountainous and remote locations. Dedicated protocols for the use of PPE appropriate for SAR rescuers exerting physical effort in remote areas and using technologies such as drones, telemedicine, and localization and contact tracing applications could contribute to an effective and timely emergency response in mountainous and remote settings.
Collapse
Affiliation(s)
- Michiel J. van Veelen
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
| | - Anna Voegele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesia and Intensive Care, “F. Tappeiner” Hospital, Merano, Italy
| | - Marc Kaufmann
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
- Emergency Medical Services 112, Health Care System Alto Adige, Bolzano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
45
|
Schierbeck S, Hollenberg J, Nord A, Svensson L, Nordberg P, Ringh M, Forsberg S, Lundgren P, Axelsson C, Claesson A. Automated external defibrillators delivered by drones to patients with suspected out-of-hospital cardiac arrest. Eur Heart J 2021; 43:1478-1487. [PMID: 34438449 DOI: 10.1093/eurheartj/ehab498] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/27/2021] [Accepted: 08/05/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS Early defibrillation is critical for the chance of survival in out-of-hospital cardiac arrest (OHCA). Drones, used to deliver automated external defibrillators (AEDs), may shorten time to defibrillation, but this has never been evaluated in real-life emergencies. The aim of this study was to investigate the feasibility of AED delivery by drones in real-life cases of OHCA. METHODS AND RESULTS In this prospective clinical trial, three AED-equipped drones were placed within controlled airspace in Sweden, covering approximately 80 000 inhabitants (125 km2). Drones were integrated in the emergency medical services for automated deployment in beyond-visual-line-of-sight flights: (i) test flights from 1 June to 30 September 2020 and (ii) consecutive real-life suspected OHCAs. Primary outcome was the proportion of successful AED deliveries when drones were dispatched in cases of suspected OHCA. Among secondary outcomes was the proportion of cases where AED drones arrived prior to ambulance and time benefit vs. ambulance. Totally, 14 cases were eligible for dispatch during the study period in which AED drones took off in 12 alerts to suspected OHCA, with a median distance to location of 3.1 km [interquartile range (IQR) 2.8-3.4). AED delivery was feasible within 9 m (IQR 7.5-10.5) from the location and successful in 11 alerts (92%). AED drones arrived prior to ambulances in 64%, with a median time benefit of 01:52 min (IQR 01:35-04:54) when drone arrived first. In an additional 61 test flights, the AED delivery success rate was 90% (55/61). CONCLUSION In this pilot study, we have shown that AEDs can be carried by drones to real-life cases of OHCA with a successful AED delivery rate of 92%. There was a time benefit as compared to emergency medical services in cases where the drone arrived first. However, further improvements are needed to increase dispatch rate and time benefits. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT04415398.
Collapse
Affiliation(s)
- Sofia Schierbeck
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Jacob Hollenberg
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Anette Nord
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Leif Svensson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Per Nordberg
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Mattias Ringh
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Sune Forsberg
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| | - Peter Lundgren
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Arwid Wallgrens backe, 413 46 Gothenburg, Sweden.,Prehospen-Centre for Prehospital Research, University of Borås, 501 90 Borås, Sweden.,Department of Cardiology, Region Västra Götaland, Sahlgrenska University Hospital, Blå stråket 5, 413 45 Gothenburg, Sweden
| | - Christer Axelsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Arwid Wallgrens backe, 413 46 Gothenburg, Sweden.,Prehospen-Centre for Prehospital Research, University of Borås, 501 90 Borås, Sweden
| | - Andreas Claesson
- Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet, Södersjukhuset Sjukhusbacken 10, Solna, 118 83 Stockholm, Sweden
| |
Collapse
|
46
|
Hirayama I, Doi K, Yamamoto M, Toida C, Morimura N. Evaluation of Autonomous Actions on Bystander-Initiated Cardiopulmonary Resuscitation and Public Access Defibrillation in Tokyo. Int Heart J 2021; 62:879-884. [PMID: 34276018 DOI: 10.1536/ihj.21-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The frequencies of autonomous bystander-initiated cardiopulmonary resuscitation (CPR) and public access defibrillation have not yet been clarified. We aimed to evaluate the frequency of autonomous actions by citizens not having a duty to act.This retrospective observational study included patients who suffered an out-of-hospital cardiac arrest (OHCA) in Tokyo between January 1, 2013 and December 31, 2017. The Delphi method with a panel of 11 experts classified the locations of OHCA resuscitations into 3 categories as follows; autonomous, non autonomous, and undetermined. The locations determined as autonomous were further divided into 2 groups; home and other locations. Bystander-initiated CPR and application of an automated external defibrillator (AED) pad were evaluated in 43,460 patients with OHCA.Group A (non autonomous), group B (autonomous, not home), and group C (home), consisted of 7,352, 3,193, and 32,915 patients, respectively. Compared with group A, group B and group C had significantly lower rates of bystander-initiated CPR (group A, B, C; 68.3% versus 38.6% versus 23.9%) and AED pad application (groups A, B, C; 26.8% versus 15.1% versus 0.6%). In addition, multivariate analysis demonstrated that an autonomous location of resuscitation was independently associated with the frequencies of bystander-initiated CPR and AED pad application, even after adjusting for age, sex, and witness status.Autonomous actions by citizens were unacceptably infrequent. Therefore, the education and training of citizens is necessary to further enhance autonomous CPR.
Collapse
Affiliation(s)
- Ichiro Hirayama
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo
| | - Kent Doi
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo
| | - Miyuki Yamamoto
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo
| | - Chiaki Toida
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo
| | - Naoto Morimura
- Department of Acute Medicine, Graduate School of Medicine, The University of Tokyo
| |
Collapse
|
47
|
Kim HJ, Kim JH, Park D. Comparing audio- and video-delivered instructions in dispatcher-assisted cardiopulmonary resuscitation with drone-delivered automatic external defibrillator: a mixed methods simulation study. PeerJ 2021; 9:e11761. [PMID: 34316403 PMCID: PMC8286704 DOI: 10.7717/peerj.11761] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/21/2021] [Indexed: 11/20/2022] Open
Abstract
This study compared first responders' cardiopulmonary resuscitation (CPR) performance when a dispatcher provides audio instructions only and when both audio and video instructions are given. In the simulation, an automatic external defibrillator (AED) was delivered via drone in response to a cardiac arrest occurring outside a hospital setting. Participants' qualitative experiences were also explored.An exploratory sequential mixed methods design was used. AEDs were delivered to college students via drone with one group receiving both audio and video instructions and the other receiving audio-only instruction, and differences in CPR performance and accuracy were compared. After completion, focus group interview data were collected and analyzed. Video-based instruction was found to be more effective in the number of chest compressions (p < 0.01), chest compression rate (p < 0.01), and chest compression interruptions (p < 0.01). The accuracy of the video group for the chest compression region was high (p = 0.05). Participants' experiences were divided into three categories: "unfamiliar but beneficial experience," "met helper during a desperate and embarrassing situation," and "diverse views on drone use." Our results lay the groundwork for a development plan for providing emergency medical services using drones, as well as the preparation of guidelines for dispatchers on the provision of video instructions.
Collapse
Affiliation(s)
- Hyun-Jung Kim
- Department of Nursing, Daewon University College, Jecheon, Chungbuk, Republic of Korea
| | - Jin-Hwa Kim
- Department of Emergency Medical Technology, Daewon University College, Jecheon, Chungbuk, Republic of Korea
| | - Dahye Park
- Department of Nursing, Semyung University, Jecheon, Chungbuk, South Korea
| |
Collapse
|
48
|
Olasveengen TM, Semeraro F, Ristagno G, Castren M, Handley A, Kuzovlev A, Monsieurs KG, Raffay V, Smyth M, Soar J, Svavarsdóttir H, Perkins GD. [Basic life support]. Notf Rett Med 2021; 24:386-405. [PMID: 34093079 PMCID: PMC8170637 DOI: 10.1007/s10049-021-00885-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/13/2022]
Abstract
The European Resuscitation Council has produced these basic life support guidelines, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include cardiac arrest recognition, alerting emergency services, chest compressions, rescue breaths, automated external defibrillation (AED), cardiopulmonary resuscitation (CPR) quality measurement, new technologies, safety, and foreign body airway obstruction.
Collapse
Affiliation(s)
- Theresa M. Olasveengen
- Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norwegen
| | - Federico Semeraro
- Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italien
| | - Giuseppe Ristagno
- Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Mailand, Italien
- Department of Pathophysiology and Transplantation, University of Milan, Mailand, Italien
| | - Maaret Castren
- Emergency Medicine, Helsinki University and Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finnland
| | | | - Artem Kuzovlev
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, V.A. Negovsky Research Institute of General Reanimatology, Moskau, Russland
| | - Koenraad G. Monsieurs
- Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Antwerpen, Belgien
| | - Violetta Raffay
- Department of Medicine, School of Medicine, European University Cyprus, Nikosia, Zypern
| | - Michael Smyth
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, CV4 7AL Coventry, Großbritannien
- West Midlands Ambulance Service, DY5 1LX Brierly Hill, West Midlands Großbritannien
| | - Jasmeet Soar
- Southmead Hospital, North Bristol NHS Trust, Bristol, Großbritannien
| | - Hildigunnur Svavarsdóttir
- Akureyri Hospital, Akureyri, Island
- Institute of Health Science Research, University of Akureyri, Akureyri, Island
| | - Gavin D. Perkins
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, CV4 7AL Coventry, Großbritannien
- University Hospitals Birmingham, B9 5SS Birmingham, Großbritannien
| |
Collapse
|
49
|
Kunovjanek M, Wankmüller C. Containing the COVID-19 pandemic with drones - Feasibility of a drone enabled back-up transport system. TRANSPORT POLICY 2021; 106:141-152. [PMID: 33846672 PMCID: PMC8019130 DOI: 10.1016/j.tranpol.2021.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic has profoundly altered common social and economic patterns as governments all over the world have been forced to take drastic measures to counter the spread of the disease. Among them, quarantine, the closure of borders, and social distancing are the ones that have affected transportation systems most severely. With the clear need to avoid all unnecessary direct human contact, an increased interest in contactless transportation and delivery modes emerged. Drones are a promising alternative in this regard, especially for the delivery of essential goods, such as COVID-19 viral tests. In this study, we therefore investigate how drones can be used to distribute viral tests to potentially infected patients. The novel approach that we propose is to use existing drone infrastructure to perform this task, where drones owned and operated by different public and private entities are retrofitted for the distribution of essential goods in the case of emergency. In a wider sense, we hence suggest the establishment of a drone enabled back-up transport system. Potential performance gains are analyzed through a mathematical time and cost model that was developed in close cooperation with the state Red Cross Organization and a utility drone manufacturer. Process design as well as parameter estimation are based on empirical investigation including, but not limited to, accompanying a COVID-19 mobile testing team in the field. The practical feasibility was verified by retrofitting drones initially assigned to other purposes. Additionally, policy recommendations, such as the establishment of public-public and public-private partnerships, were identified.
Collapse
Affiliation(s)
- Maximilian Kunovjanek
- Department of Operations, Energy, and Environmental Management, Universitaet Klagenfurt, Universitätsstraße 65 - 67, 9020, Klagenfurt, Austria
| | - Christian Wankmüller
- Department of Operations, Energy, and Environmental Management, Universitaet Klagenfurt, Universitätsstraße 65 - 67, 9020, Klagenfurt, Austria
| |
Collapse
|
50
|
Abstract
PURPOSE OF REVIEW To discuss different approaches to citizen responder activation and possible future solutions for improved citizen engagement in out-of-hospital cardiac arrest (OHCA) resuscitation. RECENT FINDINGS Activating volunteer citizens to OHCA has the potential to improve OHCA survival by increasing bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Accordingly, citizen responder systems have become widespread in numerous countries despite very limited evidence of their effect on survival or cost-effectiveness. To date, only one randomized trial has investigated the effect of citizen responder activation for which the outcome was bystander CPR. Recent publications are of observational nature with high risk of bias. A scoping review published in 2020 provided an overview of available citizen responder systems and their differences in who, when, and how to activate volunteer citizens. These differences are further discussed in this review. SUMMARY Implementation of citizen responder programs holds the potential to improve bystander intervention in OHCA, with advancing technology offering new improvement possibilities. Information on how to best activate citizen responders as well as the effect on survival following OHCA is warranted to evaluate the cost-effectiveness of citizen responder programs.
Collapse
|