Unmanned aircraft systems, commonly referred to as drones, are emerging as a possible solution for medical emergencies and health care in remote areas. Drones are small aircraft; some are small enough to fit in the palm of a hand, but they can be much larger. Drones must be registered with the Federal Aviation Administration (FAA, 2021) if they weigh more than 0.55 pounds, but they cannot weigh more than 55 pounds including payload. These aircraft look like small helicopters with four to eight rotary wings for vertical lift and landings.

Drones are used in health care primarily for search and rescue missions and transport of medical devices, medications, defibrillators, testing supplies, and blood to remote areas. This article explores the possibilities and limitations of using drones in health care and presents the use of drone technology in nursing education.

SEARCH AND RESCUE

Drones have distinctive capabilities that are used by emergency service providers worldwide and have saved thousands of lives. Drones are fast and cheap; with the added benefit of different types of sensors and communication capabilities, drones can find people in danger. For example, in 2019, a 60-year-old hiker was trapped in the Snowy Canyon State Park, Utah, and a drone was sent as a light source to improve the visibility of the rescue team. In another situation, a drone with a thermal camera was used to search for and find an 88-year-old man who was reported missing in Texas. In 2018, a rescue team in Iceland used a drone to locate two people trapped on the side of a steep mountain (Dukowitz, 2019). There are many other similar stories.

TRANSPORT AND DELIVERY

The use of drones for delivering medical supplies or equipment has been tested in research studies. Rosamond et al. (2020) conducted a simulated drone delivery of an automated external defibrillator (AED) in five zones, which varied by environmental conditions. They measured the time from the launch of the drone to the acquisition of the AED at the cardiac arrest site. The study demonstrated that an AED could safely be delivered but the time to acquisition varied by conditions on the ground. Researchers in the United Kingdom delivered AEDs by drones over much longer distances and deployed the AED to the arrest site by parachute (Rees et al., 2021). The drone made its flight and payload drop without damage to either device. These two studies and others demonstrate the feasibility, safety, and time savings of using drones to deliver needed medical devices and supplies (Boutilier et al., 2017; Mermiri et al., 2020; Zailani et al., 2021). Moving from simulation to real use, a drone carrying an AED helped save the life of a 71-year-old man in Sweden who had an out-of-hospital cardiac arrest (Hicks, 2022).

Drones have been used in health care, mainly outside the United States, because of the flexibility of aviation laws in other countries. For instance, in Rwanda, drones are helping with the health care system. Using Zipline drone technology, a single drone transports blood bags in 15 minutes, even in extreme weather conditions, whereas conventional transportation takes over three hours. Using this technology, Rwanda has made significant progress in reducing postpartum deaths, which usually happen because of postpartum hemorrhage (Gage, 2022; World Health Organization, 2019). Furthermore, the United Nations Children's Fund uses drones to transport blood from HIV testing in hard-to-reach areas in Malawi to reduce the wait time to get results, especially for infants who might have acquired HIV from their mothers and need treatment (Allen, 2016; Mbah, 2017).

One company is developing and testing a drone for use inside a hospital. This type of technology is much less expensive and more flexible than tube systems used for sending biological samples from a nursing unit to the laboratory or delivering medications to a medication room (Tucker, 2022). Although the vision of drones to reduce delivery time is quite compelling, the reality of piloting the drone is complicated because of the inaccuracy of global positioning systems inside buildings and the high concentration of medical equipment with potential for the drone to interrupt Wi-Fi or Bluetooth systems (Tucker, 2022).

LIMITS ON DRONE USE IN THE UNITED STATES

FAA regulations and guidelines limit drone package delivery functions in the United States under normal operational limitations in 14 CFR Part 107 (FAA, 2021). For instance, while operating under 14 CFR Part 107, the remote pilot in command must maintain a visual line of sight in daylight, remain below 400 feet above ground level, and request authorization to operate in controlled airspace from the FAA.

Walmart piloted its drone delivery of at-home COVID-19 self-collection kits in September 2020 (Ward, 2020). The service was limited to single-family residences within a one-mile radius of the designated supercenters to make sure the drone was visible while flying and was operating under FAA limitations (Ward, 2020).

DRONES IN NURSING EDUCATION

Scenarios using drones in nursing education are possible with a licensed pilot and airspace authorization. A drone could be used in a disaster simulation with victims dispersed across a campus. A multidisciplinary response team, led by nursing students, could use a drone to search for victims and dispatch a rescue team while other students manage the response center with triage and treatment areas. Home health simulations could use a drone to pick up blood samples from a rural home and deliver medications prescribed based on laboratory results.

Amiri and colleagues conducted a drone simulation with undergraduate nursing students in a maternal-infant course at the University of Alabama in Huntsville (Steele, 2022). The scenario was set in a rural hospital with a pregnant woman at risk for preterm labor. The setting lacked a fetal fibronectin testing kit to predict risk for preterm labor and betamethasone for maturing fetal lungs in the event of preterm delivery. The drone delivered medical supplies from an urban hospital to the rural hospital. This simulation gave students the opportunity to learn about preterm labor and envision how drone technology can be used in health care. Amiri's team hopes the experience will also broaden students' view of nursing and let them see nurses leading innovations in health care.

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