HiRO the Drone Will Change Emergency Medical Treatment

Shortly after five o’clock on a Sunday evening in February 2013, a severe EF4 tornado ripped through Hattiesburg, Mississippi. Winds whirling around 170 mph tore through town, warping what seemed solid and upending the neighborhood. A church steeple was ripped off, together with roof after roof on main street. A vehicle parked near the baseball stadium was taken by the twister and spit out near the pitching mound in the middle of the area, based on the storm record.

As soon as he saw the wreckage on TV–homes reduced to rubble, power lines snapped, mangled trees and traffic lights–Dr. Italo Subbarao panicked.

“I remember thinking, 'I can see my grandmother’s house,'” he recalled. “'However, an ambulance can not get out there! '”

That his grandmother was remote and isolated from emergency help sparked stress within Subbarao, an osteopathic physician specializing in emergency care.

So he started tinkering with a solution: an aerial ambulance that may fly over the chaos on the ground, with live-saving medical equipment in tow.

With the support of a team headed by Dennis Lott, director of the unmanned aerial vehicle program at Hinds Community College in Mississippi, and Guy Paul Cooper Jr., D.O., then a fourth-year medical student in the William Carey University College of Osteopathic Medicine (where Subbarao is a senior associate dean), a new drone was born. They gave the altered DJI S1000+ drone with a title worthy of a comic book cover: HiRO (Health Integrated Rescue Operations).

HiRO was “unveiled” in October. From the area, the drone acts as a 911 link to a remote, on-call doctor, who uses an augmented reality interface to give bystanders directions to supply easy, Good Samaritan medical care until emergency personnel arrive.

Next February, the team will take part in a big disaster exercise with the Mississippi Emergency Management Agency (MEMA).

The drone includes a glowing orange, hard-cased medical package that could treat up to 100 individuals in a catastrophe, such as a mass shooting, a terrorist event, a jungle crisis, or even a hurricane. The medical kits range between 2 to 20 pounds based on emergency, with supplies contained in an automated medication bin.

“They’re designed to be modular so that we can make alterations as necessary,” Cooper stated, that has designed several prototypes.

The system includes a camera attached to the health kit and a pair of smart glasses.

“We request the bystander to put the glasses,” Subbarao explained. “We can see what they see” The remote, on-call doctor uses a Microsoft HoloLens headset and a holographic health record screen to communicate with all the bystander on the ground.

The drone can also potentially assist bystanders stabilize wounded individuals in more frequent disasters, such as a heart attack, a terrible fall, or a severe allergic reaction.

The tech aims a region of the medical system that’s frequently overlooked: the valuable minutes prior to a patient arrives in the hospital. If rolled out fully, a fleet of HiRO drones could fundamentally streamline triage on the ground, enhance access to care, and lessen the formidable pressure hospital emergency rooms face when disaster strikes.

“The drone owner will be distinct from the medical tech,” explained Elizabeth Smith-Trigg, a William Carey University College of Osteopathic Medicine administrator who’s supporting the job. “The machine will be incorporated with local 911 services or via the State Emergency Management Alert System,” she added.

A recent research printed in JAMA Surgery of over 1.8 million 911 calls found that, normally, bystanders in rural regions has to wait twice as long to get an ambulance than city-dwellers and suburbanites–roughly 13 minutes to get a property, in contrast to 6 minutes to the urban one. Approximately 10 percent of people in rural areas had to wait for 30 minutes for an ambulance, researchers found. The study’s authors offer one solution: the “You Are the Help Until Help Arrives” campaign, that is a string of movies and tools supported by the Federal Emergency Management Agency (FEMA). The idea is to flip bystanders — put individuals with little medical knowledge–to immediate responders with easy directions, such as how to administer CPR and control bleeding using a make-shift tourniquet (“Cease the Bleed”).

Medical drones like HiRO–for example people that provide blood, take defibrillators, and transportation laboratory samples in rural and underserved areas–are currently only able to operate globally. That is because a GPS-enabled drone can not legally fly beyond the operator’s visual line of sight” (BVLoS), that can be limited by the Federal Aviation Administration (FAA). Subbarao reported that he felt optimistic that an “exemption” for disaster or “other regulatory allowance” for BVLoS “will come to fruition within the following year.”

Presently, in a disaster scenario, the HiRO team has to first request a Public Agency Certificate of Authorization (COA). The acceptance procedure for a crisis, fast-tracked COA may take at the fastest two weeks, but can go up to 24 hours –a potentially dangerous timeline in a crisis. Subbarao explained that the FAA target for acceptance is two hours, but declined to comment on the “intricacies of acceptance.” Subbarao’s team first asked a special “exemption” in the FAA last year, and securing regulatory approval was a significant challenge. “Ours is a need,” he explained.

In October, President Donald Trump established a program to enlarge drone usage, with a goal of devoting at least five pilot jobs. The testing procedure has entailed working locally with MEMA, but Subbarao explained that he appears at HiRO as a “global solution.”

“It may be used in suburban and city surroundings in addition to rural surroundings,” he explained. “We envision the technology to be incorporated with 911 and the emergency response system” Subbarao reported that to get FDA approval and show that HiRO is capable of functioning in a crisis situation, he’s looking to fly and examine with national agencies that work with emergency response, like the National Guard. However, Subbarao reported that it might be too soon for us to scan the heavens for HiRO from the 2018 hurricane season.

“In fact, the FAA is well aware of the technology we are working on. They’re directing us” Subbarao explained. “But we’ll get there. We’ll convince them.”


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