Simulation and educationDelivery of Automated External Defibrillators via Drones in Simulated Cardiac Arrest: Users' Experiences and the Human-Drone Interaction
Section snippets
INTRODUCTION
The majority (73%) of the 475,000 sudden cardiac arrests in the United States (US) each year occur outside of the hospital.1, 2 After an out-of-hospital cardiac arrest (OHCA), survival to hospital discharge in the United States (US) is 10.6%, and survival with good neurological function is 8.6%.1 When a bystander applies an automatic external defibrillator (AED) to a victim of OHCA prior to ambulance arrival, the chance of survival is nearly doubled (Fig. 1).3 However, the likelihood of
METHODS
Between March and June 2019, we conducted 35 OHCA simulation trials in five distinct zones outdoors across the University of North Carolina-Chapel Hill (UNC) campus.17 Each trial included a life-sized manikin (Laderal Resusci Anne) as the OHCA victim, accompanied by two participants, paired by sex and age (18-34, 35-49, 50-65 years). We randomized participants either to call a mock 9-1-1 telecommunicator who initiated the autonomous flight of a drone modified to carry a standard AED (Philips
RESULTS
We conducted 35 trials, 18 with female pairs and 17 with male pairs. These included 15, 11 and 9 trials across three age strata (18-34, 35-49, and 50-65 years), respectively. In seven of the 35 trials, only one participant was present and performed both roles as a caller and seeker sequentially. We conducted semi-structured qualitative interviews with 17 of the 35 participants that served in the drone-recipient role (Table 1). Analysis of the interviews focused on four key thematic domains: (1)
DISCUSSION
In this community-based OHCA simulation study, we found participants were overwhelmingly positive about their interactions with an AED-equipped drone. Many felt relieved and comforted in having life-saving equipment directly delivered, enabling them to stay with the victim and continue CPR. A few expressed concerns surrounding technical aspects of the AED-drone delivery system, including potential safety issues related to moving propellers. All expressed willingness to use an AED drone in a
Limitations
Our study was limited to a small sample of participants all affiliated with a university setting. Participants, therefore, may not reflect the general population. While informative, it is difficult to know how participants might feel or respond in a true OHCA event. Our simulation study was controlled, both in study design and in execution on the campus during daylight hours and in good weather, and limited to simulations conducted outdoors due to campus and Federal Aviation Administration
Conclusion
Overall, participants reported a positive experience interacting with an AED-equipped drone responding to a simulated OHCA, and all reported a willingness to use the system in a real-life OHCA emergency. AED drone delivery systems can be further improved to enhance both the user experience and delivery process by addressing the concerns noted by participants and considering their suggestions. Despite our study being a simulation, participants’ discomfort with performing CPR and using an AED
Funding
The project described was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through Grant Award Number UL1TR002489. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Conflict of interest statement
All authors report no conflicts of interest.
CRediT authorship contribution statement
Jessica K. Zègre-Hemsey: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Supervision, Writing - original draft, Writing - review & editing. Mary E. Grewe: Data curation, Formal analysis, Writing - review & editing. Anna M. Johnson: Data curation, Project administration, Writing - review & editing. Evan Arnold: Project administration, Writing - review & editing. Christopher J. Cunningham: Writing - review & editing. Brittany M. Bogle:
Acknowledgements
The authors thank all participants, the UNC Public Safety Department, and the UNC campus community. We are indebted to Bailey DeBarmore, Fola Omofoye, Michael Picinich, and Eugenia Wong for their time and contributions.
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