Drones reduce the treatment-free interval in search and rescue operations with telemedical support - A randomized controlled trial

INTRODUCTION

Response to medical incidents in mountainous areas is delayed due to the remote and challenging terrain. Drones could assist in a quicker search for patients and can facilitate earlier treatment through delivery of medical equipment. We aim to assess the effects of using drones in search and rescue (SAR) operations in challenging terrain. We hypothesize that drones can reduce the search time and treatment-free interval of patients by delivering an emergency kit and telemedical support.

METHODS

In this randomized controlled trial with a cross-over design two methods of searching for and initiating treatment of a patient were compared. The primary outcome was a comparison of the times for locating a patient through visual contact and starting treatment on-site between the drone-assisted intervention arm and the conventional ground-rescue control arm. A linear mixed model (LMM) was used to evaluate the effect of using a drone on search and start of treatment times.

RESULTS

Twenty-four SAR missions, performed by six SAR teams each with four team members, were analyzed. The mean time to locate the patient was 14.6 min (95% CI 11.3-17.9) in the drone-assisted intervention arm and 20.6 min (95% CI 17.3-23.9) in the control arm. The mean time to start treatment was 15.7 min (95% CI 12.4-19.0) in the drone-assisted arm and 22.4 min (95% CI 19.1-25.7) in the control arm (p < 0.01 for both comparisons).

CONCLUSION

The successful use of drones in SAR operations leads to a reduction in search time and treatment-free interval of patients in challenging terrain, which could improve outcomes in patients suffering from traumatic injuries, the most commonly occurring incident requiring mountain rescue operations.

COVID-19 Pandemic in Mountainous Areas: Impact, Mitigation Strategies, and New Technologies in Search and Rescue Operations

van Veelen, Michiel J., Anna Voegele, Simon Rauch, Marc Kaufmann, Hermann Brugger, and Giacomo Strapazzon. COVID-19 pandemic in mountainous areas: impact, mitigation strategies, and new technologies in search and rescue operations. High Alt Med Biol. 22:335-341, 2021.-Mitigating the spread of COVID-19, an airborne infection, can lead to delays in the prehospital response and impair the performance of search and rescue (SAR) services in mountainous and remote areas. We provide an overview of the developing epidemiological situation related to the COVID-19 pandemic in mountainous areas and review current protocols to determine their suitability for mountain rescue teams. We also discuss using novel technologies to reduce the adverse effects caused by COVID-19 mitigation strategies such as delays caused by donning personal protective equipment (PPE) and reduced rescuer performance due to impaired movement and ventilation. COVID-19 has spread even in mountainous and remote locations. Dedicated protocols for the use of PPE appropriate for SAR rescuers exerting physical effort in remote areas and using technologies such as drones, telemedicine, and localization and contact tracing applications could contribute to an effective and timely emergency response in mountainous and remote settings.

Long term consistency and location specificity of equine gluteus medius muscle activity during locomotion on the treadmill

Background

The equine m. gluteus medius (GM) is the largest muscle of the horse, its main movement function is the extension of the hip joint. The objective of the present study was to measure equine GM activity in three adjacent locations on GM during walk and trot on a treadmill, in order to document potential differences. Fourteen Haflinger mares were measured using surface electromyography and kinematic markers to identify the motion cycles on three occasions over 16 weeks. The electrodes were placed on left and right gluteus medius muscle over the middle of its widest part and 5 cm lateral and medial of it. For data processing, electrical activity was normalised to its maximum value and timing was normalised to the motion cycle. A Gaussian distribution approach was used to determine up to 10 modes of focussed activity, and results were analysed separately for stance and swing phase of the ipsilateral hindlimb.

Results

Fair reliability was found for mean mode values (Cronbach’s alpha = 0.66) and good reliability was found for mean mode locations (Cronbach’s alpha = 0.71) over the three data collection days. The magnitude of muscle activity identified as mean mode value was much larger at trot than at walk, and mean mode value was significantly different between stance phases of walk and trot for all electrode positions (p < 0.01). The pattern of muscle activity identified as mean mode location was significantly different for walk and trot at all electrode positions, both during stance and swing phases (p < 0.001). This indicates the different timing pattern between the gaits. Results of the three electrode positions on the same muscle during each gait were not significantly different when comparing the same measurement.

Conclusions

The middle of the equine GM does not show any indication of functional differentiation during walk and trot on a treadmill; this might be due to lack of segmentation as such, or due to lack of need for segmented use for these very basic main tasks of the muscle. The reliability of the sEMG measurements over several weeks was fair to good, an indication for the robustness of the methodology.