When Seconds Count: Can Drone-AED Networks Change OHCA Survival?

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Survival after out‑of‑hospital cardiac arrest hinges often on getting an AED to the patient within minutes - but in most communities (especially more rural areas), that simply doesn’t happen fast enough. First responders often arrive too late, and bystanders rarely have immediate access to a device. This study explores whether pairing first responders with strategically deployed AED‑carrying drones could finally make 5‑minute defibrillation a reality. Join Dr. Boyer as he breaks down what this model suggests about the future of rapid OHCA response.

Monique A. Starks, Jamal Chu, K.H. Benjamin Leung, Audrey L. Blewer, Denise Simmons, Carolina Malta Hansen, Anjni Joiner, José G. Cabañas, Matthew R. Harmody, R. Darrell Nelson, Bryan F. McNally, Joseph P. Ornato, Christopher B. Granger, Timothy C.Y. Chan, Daniel B. Mark. Combinations of First Responder and Drone Delivery to Achieve 5-Minute AED Deployment in OHCA, JACC: Advances, Volume 3, Issue 7, Part 2, 2024, 101033, ISSN 2772-963X, https://doi.org/10.1016/j.jacadv.2024.101033.

Background and Study Design

Out-of-hospital cardiac arrest (OHCA) survival in the United States has remained at approximately 8-10% for over 30 years, despite evidence that immediate CPR and defibrillation within the first few minutes improves survival rates. The primary barrier is timely access to automated external defibrillators (AEDs), with fewer than 10% of cardiac arrest patients receiving an AED before EMS arrival.

Starks and colleagues conducted a modeling study using data from 28,292 OHCA patients aged ≥18 years across 48 North Carolina counties between 2013-2019, utilizing the Cardiac Arrest Registry to Enhance Survival (CARES) registry. The study evaluated two sequential interventions: (1) equipping all first responders with AEDs, and (2) adding an optimized drone delivery network.

Key Findings

Baseline Performance:

  • Median county-level response time (9-1-1 call to AED arrival): 8.0 minutes

  • Proportion of OHCAs with AED arrival 5 minutes: 16.5%

Intervention 1 - Universal First Responder AED Deployment:

  • Median response time improved to 7.0 minutes

  • Proportion with 5-minute AED arrival increased to 22.3%

Intervention 2 - First Responder AEDs + Optimized Drone Network:

  • 326 drones strategically placed across 48 counties at EMS, fire, and police stations

  • Median response time improved to 4.8 minutes

  • Proportion with 5-minute AED arrival increased to 56.3% (more than tripling baseline)

  • Response time improved for 66.5% of OHCAs compared to Intervention 1 alone

Clinical Impact

For witnessed OHCAs where drone arrival occurred in 5 minutes and ahead of first responders and EMS:

  • Initial shockable rhythm rates predicted to increase from 30.2% to 35.0% (16% relative increase)

  • Survival to hospital discharge predicted to increase from 14.5% to 19.4% (34% relative increase)

  • For witnessed shockable arrests specifically, survival expected to increase from 15% to 20%

Equity Considerations

The drone network demonstrated particular benefit in rural counties with longer baseline response times. The intervention reduced between-county variability in median response times, potentially addressing geographic disparities in early defibrillation access.

 EM Physician Takeaway

Advocate for universal AED deployment with your first responders. Keep an eye on drone AED programs. Remember that every minute counts. Whether it's improving dispatch times, encouraging bystander CPR, or exploring new delivery methods, keep pushing to get defibrillation to patients faster. 

AUTHORSHIP

Written by: Lucas Boyer MD, PGY-3 University of Cincinnati Department of Emergency Medicine

Editing, Posting, and Audio Editing by Anita Goel, MD; Associate Professor, APD of UC EM Residency Program, and Co-editor of Tamingthesru.com

Cite as: Boyer, L., Goel, A. When Seconds Count: Can Drone-AED Networks Change OHCA Survival? TamingtheSRU.com. www.tamingthesru.com/blog/journal-club/aed-drones-for-out-of-hospital-cardiac-arrest. 3/30/2026.