Inspired by an urgent need to improve timely defibrillation for out-of-hospital cardiac arrests (OHCA) in dense urban settings, a team of investigators developed a simulation that explored the potential of leveraging an existing food delivery network in Taipei City, Taiwan, to help address this challenge. Their findings in the Canadian Journal of Cardiology , published by Elsevier, suggest that deploying food delivery riders to deliver defibrillation may reduce automated external defibrillator (AED) response times by approximately three minutes—about 50% faster than a traditional emergency medical system (EMS)—and might be particularly beneficial during peak hours.
Lead investigator Kuan-Chen Chin, MPH, Department of Emergency Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, and Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan, explains, "Each minute of delay in defibrillation reduces the survival rate by 7–10%. Our approach leverages an existing, widespread urban workforce to address a well-known weak link in the chain of survival. We found that it offers a cost-effective and scalable strategy for improving OHCA outcomes in high-density cities, where EMS cannot always provide immediate defibrillation."
Densely populated Taipei has a high concentration of food delivery (FD) scooter riders. To examine the feasibility of utilizing these FD riders as first responders for AED delivery in OHCA incidents investigators conducted a city-scale simulation using real-world OHCA data from the Registry of the Taipei City Fire Department between 2017 and 2019, public defibrillator locations, and food delivery patterns and hotspots using the Uber Eats platform.
The simulation assumed that every open restaurant in a hotspot had one FD rider waiting and ready to respond to OHCAs within a two-kilometer radius. FD riders' response rates were varied, and simulated defibrillator arrival times were compared to documented fire department delivery times of six to seven minutes. Differences in defibrillator arrival times during peak and off-peak hours were also assessed.
With a 10% FD rider response rate, the defibrillator arrival time decreased by 2.99 minutes, representing approximately 44% of the original EMS response time. In the simulation, over 60% of OHCAs were successfully attended. Achieving 80% coverage during peak hours required 13.4% of FD riders to respond.
According to co-corresponding investigator Albert Y. Chen, PhD, Department of Civil Engineering, National Taiwan University, Taipei City, Taiwan, "Integrating FD riders into the EMS system could reduce defibrillator arrival times, decreasing patient waiting time for defibrillation. This approach is particularly effective during peak hours, when a higher proportion of OHCAs can be addressed."
"We were encouraged to see that even low response rates might yield meaningful time savings, and that the model appeared effective during off-peak hours despite reduced availability," adds co-corresponding investigator Jen-Tang Sun, MD, MS, Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
