County of Simcoe paramedics exploring drones, other options to reach cardiac arrest patients faster

Chances of surviving a cardiac arrest drop by 7 to 10 per cent with each passing minute without cardiopulmonary resuscitation (CPR) and defibrillation.

According to a report to Simcoe County Council committee of the Whole this week, Simcoe County’s geography and population distribution create challenges for responders to arrive to make a difference. County of Simcoe Paramedic Services (CSPS) provided an update on what avenues are being explored to improve response times.

“We wanted to identify what are the areas that have shown historically to indicate long response times for cardiac patients, and maybe we can target them with different approaches to increase the survival of people that have cardiac arrest episodes in those areas,” says Andrew Robert, Director and Chief of County of Simcoe Paramedic Services.

Robert says the pandemic has impacted the CSPS ability to expand and grow community-based training and distribution of public access defibrillators (PAD).

“We have approximately 700 of those defibrillators in the communities,” says Robert.

The list includes schools, public buildings, private businesses, and even some cottage associations and individuals have them.

In the report to the county, CSPS listed some opportunities for expansion of the PAD program:

• Student Training: Engaging local school boards to identify opportunities to provide CPR
  and AED training to students could significantly enhance the number of trained community
  members. Staff have undertaken early discussions with the Simcoe County Catholic
  School Board with an invitation to follow up in the fall.

• Marketing: Enhance marketing and outreach efforts to raise awareness of available
  training and ease of AED use. Staff are currently undertaking planning in this regard to
  increase defibrillation placements and training. This may include approaching existing
  organizations such as service clubs and cottage associations etc.

“We’re certainly looking at opportunities as outlined in the report and how we can make a bigger splash and a bigger impact on training people to be able to recognize cardiac arrest and to do CPR,” Robert explains.

Another avenue CSPS is exploring is the use of an alert system for community responders.

“These programs involve the response of pre-selected and enrolled volunteer responders within
the community. Such programs are outside of but act in coordination with current traditional
emergency response,” according to the update to council. “Community responders are alerted through the use of a smartphone application (app), of a potential cardiac arrest near them.”

“In rural or remote areas, these responders may represent the closest and quickest available help to someone in need.”

The identification, selection, and enrollment of these community responders can be based on several criteria such as:

• Existing members of the first response community;

• Health care workers;

• Other identified groups

• Clearances may include a police criminal reference check or a vulnerable sector check

The program may include training and orientation on items such as scene and personal safety, personal protective equipment (PPE), patient privacy, and response techniques, as well as first aid, CPR, and defibrillation.

Robert says the pandemic has shifted a lot of their attention and efforts, though he maintains they are not done with exploring a community responders plan.

CSPS continues to explore drone delivery as another method to reduce the time to deliver a defibrillator to a patient in cardiac arrest. Two drone delivery programs are currently under review.

• Contracted Drone Delivery: In this model, an external company is contracted to operate,
  fly and return the drones to their initial starting point. Drones are deployed from set
  locations pre-determined based on local demands and response times. This model is still
  currently not operational, but in the research phase for the delivery and drop of AED’s and
  medical equipment. Transport Canada approvals for this use are not yet in place.

• Self-Operated Drone Delivery: Internal staff are trained as drone pilots to deploy, operate
  and reset drones. Drones can be deployed from pre-set locations based on local
  demands and response times or be used as and where needed. Models similar to this are
  currently being used in Emergency Services throughout Canada, most notably in Renfrew
  County. The added benefit to this model is that the drone can be configured to support
  various mission profiles including delivery of payloads such as defibrillators, medications
  and safety equipment, or for surveying large incident scenes etc. Use is currently
  restricted to Line-of-Sight operations, which reduces the operational arena significantly.
  

CSPS is working with Volatus Aerospace, based at Lake Simcoe Regional Airport in Oro-Medonte, to discuss opportunities to develop drone technology for local use.

“I think the most efficacious model is something where there are automated triggers and automated flight that is not available right now,” says Robert. “What we are trying to do is move the needle with Volatus Aerospace to impact the way the federal government authorizes that type of application, which isn’t in play right now for our purposes.”

Across the board, Robert says there are exciting opportunities.

“It’s certainly a lot of new ground, and it will take us time to find the right formulation to make it happen and impact our communities as best we can do,” he says. “Our paramedics and all of our first response partners want to do everything we can to increase survival.”

Robert says his next step is to get more “meat on the bone” and present County Council with a plan and budget.

“Maybe we can look for sponsorship or anything like that to support some of these approaches to really enhance the safety and survivability within our diverse community.”