Sweden is investing in defibrillator-carrying drones to improve its rescue service
When an alarm sounds in Everdrone’s control room on the outskirts of Gothenburg, it means that there is a medical emergency and its remote pilots should prepare to send an automated drone buzzing through the sky.
Since 2019, the Swedish drone developer Everdrone has collaborated with researchers at Stockholm’s Karolinska Institutet and the country’s rescue organization to explore the use of drones to deliver automated external defibrillators (AEDs) to cardiac arrest patients, wherever they are.
“An autonomous system that can start immediately and have no traffic problems will be in place much faster than an ambulance,” said Everdrone founder and CTO Maciek Drejak.
“You still need an ambulance to take care of the patient, but if we can deliver the AED just minutes earlier, the payoff is huge. The probability of survival drops by about 10 percentage points per minute, so every minute counts, every second actually counts.”
Traditionally low survival rate
Karolinska Institutet’s associate professor Andreas Claesson says that Sweden’s emergency care receives reports of approximately 6,000 cardiac arrests per year; only about ten percent of these patients survive.
About 70 percent of cardiac arrests outside hospitals occur in private homes without defibrillators nearby, he says.
“We know that if it is possible to use a defibrillator within the first three to five minutes, about 50 percent of all patients can survive,” says Claesson.
“So we need to find new ways to deliver AED in the first few minutes.”
The process begins like any other emergency; calls to Sweden’s emergency number 112 are sent to one of SOS Alarm’s alarm centers.
Approximately 3.4 million calls are received annually.
How it works
If the call officer suspects a cardiac arrest and the patient is in the trial area, a drone is sent, together with more traditional rescue services.
Mattias Regnell, head of innovation at SOS Alarm, says that the drone system is electronically integrated with the emergency transmission system.
“When they put the pin on the map, the system automatically knows that in this area a drone must be sent,” he explained.
During a study initiated in February 2020, a total of 14 suspected cases of cardiac arrest were eligible for drone delivery. Of these, drones were sent to 12 and AEDs were delivered to all but one.
“People are willing to help, and if we can just refine the system to help our callers get viewers to use AEDs often, then we’ll see an increase in cases,” Regnell said.
In most cases during the four-month study, the automated drone arrived at the emergency room on average about two minutes earlier than the ambulance, but those behind the project believe that this can grow to three or four minutes earlier with some features.
Patrik Segerfelt, head of a participating dispatch center in western Gothenburg, says that even when the AED was not used, it provided comfort to people on the spot because it said that help was on the way.
“Someone said it was comforting to know, even if it was in those cases [where] it did nothing but comfort the people on the spot, because it was first, he said.
“First before fire and rescue and ambulance and police. Then they knew we were at the triage center, we knew where they were.”
The pilot’s first successes
In December last year, the project had its first real success, when an automated drone helped save the life of a 71-year-old man in the Swedish city of Trollhättan, about 75 km north of Gothenburg.
Dr Mustafa Ali was on his way to work when he saw the man collapse in his driveway. He was quickly diagnosed with cardiac arrest and called the emergency services.
“After about one, two minutes. I think (I heard) something in the air, but it’s not like a helicopter, so I looked up and there’s a drone,” Ali recalls.
“At first I thought it was someone filming here, but at the same time [someone] from the emergency center said: ‘Here’s your defibrillator, so just pick it up.’ Okay!”
Everdrone says the time between the alarm and the AED delivery was just over three minutes.
Ali used the drone’s defibrillator and continued defibrillation in the ambulance. The patient survived.
When the AED is delivered, the drone goes down to about 30 meters and then winches down the package.
Restrictions
Those behind the project say that the application is best suited for suburban areas, far from hospitals in the center.
While the drones are autonomous, remote pilots monitor the entire flight and receive take-off permits from local air traffic control.
Of course, flights are limited by battery and range. Adverse weather, such as rain and wind, can also prevent some travel.
An ongoing follow-up study began in April 2021 and will be completed this spring.
The service can currently reach 200,000 inhabitants in Sweden and is expected to be expanded to more European locations this year.
Everdrones Drejak believes that drones can be used in other parts of emergencies, and delivers items such as EpiPens.
“I am convinced that this type of system will become part of normal emergency services in the future,” he said.
“I see a future where you have this type of system everywhere, basically, and obviously there are other things you can deliver than AED that you need very quickly in an emergency.”