Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance

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Circulation: Cardiovascular Quality and Outcomes, Ahead of Print.
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.

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