When someone collapses from a heart attack, chances of survival fall 10% with every passing minute without defibrillation. Now, scientists from one of the most advanced healthcare hubs on the planet have come up with a novel way to reach cardiac arrest events faster – using food delivery riders as first responders.
Researchers from National Taiwan University (NTU) have come up with a way to significantly improve the chance of survival for those suffering an out-of-hospital cardiac arrest (OHCA), particularly in dense city and urban environments, using a simulation with real-world heart attack data to see if delivery riders could cut wait times in an emergency.
If you've spent even a day in Taipei, you'll know that it's a city packed with food outlets – and scooters (or mopeds). And while the Taiwan capital has one of the most efficient and well-run public transport systems in the world, it has a traffic problem, particularly during peak hours. While there are no shortage of hospitals in the city – Taiwan remains at the top of the world rankings in healthcare – the sprawling network of narrow lanes and busy main streets are a challenge for four-wheeled vehicles responding to emergencies.
So what if speedy, food-delivery riders could also serve as OHCA first responders? The researchers put this to the test, using OHCA incident data from the Registry of the Taipei City Fire Department between 2017 and 2019, combined with information about public defibrillator locations and food delivery patterns and hotspots from Uber Eats.
In the simulation, it was assumed that every open food outlet in a hotspot had at least one food-delivery rider nearby who could respond to an OHCA emergency within a 2-km (1.2-mile) radius. The researchers then assumed that riders could then travel at around 34.5 km/h (21.4 mph) in their radius.
The model started with Taipei’s current average: emergency medical system (EMS) teams take about 6.8 minutes to arrive at an OHCA incident with a defibrillator. If just 10% of food delivery riders in the area responded, the average arrival time dropped by about three minutes, to 3.8 minutes. That means the automated external defibrillator (AED) got there in roughly half the time compared with traditional ambulance services. At that level of response – just 10% of riders – more than 60% of cardiac arrest cases could be successfully treated. With 30% participation, that figure rose to 86%.
"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," said co-corresponding investigator Jen-Tang Sun, M.D., from Far Eastern Memorial Hospital in New Taipei City.
During peak hours, when riders are most densely clustered, only about 13% of them needed to respond to cover 80% of cardiac arrest events. Off-peak hours were less efficient, but even modest rider participation could dramatically increase AED coverage.
"Each minute of delay in defibrillation reduces the survival rate by 7–10%," said lead investigator Kuan-Chen Chin from NTU Hospital. "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," he added.
Other advantages are that the riders who service specific neighborhoods are not just fast and mobile but are adept at navigating Taipei's web of lanes, are knowledgeable when it comes to navigation, and are able to ride onto and park on sidewalks. So they could make excellent candidates for carrying this life-saving equipment where response time is critical.
Various methods to improve response times have been trialed around the world – most notably using drones to fly in AEDs. But food-delivery (FD) riders are a constant presence on Taipei's streets, often waiting for jobs just a few hundred meters away from potential emergencies, and they're motivated to respond quickly by the very nature of their work.
Naturally, such a plan has its challenges too. This was a simulation study rather than a live trial, and it rests on several optimistic assumptions – such as AEDs being available, rider participation and consistent travel speeds through traffic. (That said, most intersections in Taipei have dedicated areas at traffic lights, for riders to make their way to the front of the line when stopped.) Riders would also need basic training in CPR and AED use, as well as guidance from emergency dispatchers. Ensuring safety, liability protection and appropriate incentives would be crucial before such a system could be implemented.
Still, the concept aligns with a broader push to make AEDs more accessible outside of hospitals and clinics. Public defibrillators are often locked away in buildings or overlooked in emergencies. A gig-economy fleet armed with AEDs could bring the device directly to the person in need, within a timeframe that makes the difference between life and death.
"Integrating FD riders into the EMS system could reduce defibrillator arrival times, decreasing patient waiting time for defibrillation," said co-corresponding investigator Albert Y. Chen from NTU. "This approach is particularly effective during peak hours, when a higher proportion of OHCAs can be addressed."
It's also worth noting that while this was Taipei-specific, two-wheeled food delivery services are spread across the globe, including in densely populated cities like New York, Paris and Sydney. More than 350,000 American adults suffered an OHCA – and around 90% of these are fatal, even when treated by traditional emergency responders.
The research was published in the Canadian Journal of Cardiology.
Source: National Taiwan University via MedicalXpress
