Paris, France: Drones could be used to deliver automated external defibrillators (AEDs) to where a person is suffering an out-of-hospital cardiac arrest, according to a study presented at the European Emergency Medicine Congress today (Saturday).

AEDs can often be located some distances apart, making timely access to them uneven, particularly in rural areas or in heavily congested urban environments. However, the research presented today showed that delivering AEDs by drone, combined with providing more fixed AEDs, significantly reduced the time between an out-of-hospital cardiac arrest (OHCA) being reported and the start of defibrillation.

“Out-of-hospital cardiac arrest is a major public health issue. Survival depends strongly on early cardiopulmonary resuscitation and timely defibrillation,” Dr Hillary Minka, an emergency physician at the Lariboisière Hospital in Paris, told the congress. “Every minute of delay before defibrillation reduces the chances of survival.

“We wanted to investigate whether drones could provide faster AED access than road-based retrieval of existing fixed AEDs and thereby improve access to defibrillation across the Ile-de-France region.”

Dr Minka and her colleagues used data on OHCAs in seven departments (administrative areas) in the Île-de-France, excluding central Paris, to conduct a computer simulation study that looked at three strategies:

• Strengthening the current network of fixed AEDs
• Using drones to deliver AEDs
• Combining fixed AEDs with drones.

They divided the region into units called Ilots Regroupés pour l’Information Statistique (IRIS), which are the smallest census areas used by the French National Institute of Statistics. They estimated the amount of time needed for an AED to arrive at the centre of each unit via each of the three strategies. They also evaluated several potential locations for drone deployment, including existing AED sites, mobile intensive care units (MICUs) and fire stations.

They found that access to AEDs was very mixed, with a scarcity in the countryside and in the areas on the outskirts of Paris. To improve access to fixed AEDs, a further 1,712 AEDs would need to be added to 1,893 existing AEDs, making a total of 3,605.

Using drones significantly reduced the time spent waiting for access to an AED. The researchers found this depended both on the number of drones deployed and their geographical positioning.

In the hybrid strategy combining fixed AEDs and drones, AED access times were reduced by an average of 3.76 minutes across all IRIS units. AEDs were delivered to more than 95% of OHCA cases within five minutes, compared to only 30-40% of cases when relying on transport from existing fixed AED locations via the road network. The researchers estimated that using 200 drone bases and 871 fixed AED sites could extend AED coverage to nearly all OHCAs (28,349 cases), achieving an overall coverage rate of 99.4%.

Dr Minka said: “Our study showed that drone delivery of AEDs could reduce the times to defibrillation across all the IRIS units by several minutes, with particularly large benefits in peripheral and highly congested areas. In some cases, the time saved exceeded ten minutes.

“Our findings also suggest that this hybrid strategy could provide very broad territorial coverage while limiting the need to install hundreds of additional AEDs. This would increase the range to 3,900 metres, compared to 500 metres for fixed AEDs only.”

The researchers envisage that the drones could be operated by specially trained people or automated systems under the supervision of emergency services. When the drone arrives at the scene of an OHCA, a bystander who is already present would collect the AED and start to use it on the patient, guided by the emergency services.

“Drones will never replace bystanders, resuscitation efforts or emergency medical teams,” said Dr Minka. “However, they could represent an additional link in the chain of survival and help make defibrillation available more quickly. This study also shows that improving access to AEDs depends not only on the number of devices available, but also on how they are geographically distributed and organised. In some areas, drones could therefore represent a complementary strategy to large-scale deployment of additional fixed AEDs.”

She said the study’s findings would need to be confirmed in prospective studies and real-world experiments.

“Our findings highlight the potential value of investing in innovative solutions aimed at reducing inequalities in access to emergency care and optimising the geographical distribution of emergency resources,” she concluded.

A strength of the study is that it analysed seven departments of the Île-de-France region using a detailed geospatial approach based on real-world cardiac arrest data. A limitation is that it is a simulation study, no drones were deployed and so their performance is based on theoretical models. The drone travel time was estimated using straight line distances (“as the crow flies”) and, therefore, did not account for regulatory, meteorological or operational constraints that could influence real-world deployment.

Dr Felix Lorang is a member of the EUSEM abstract selection committee. He is head of the emergency department at Klinikum Lippe, North Rhine-Westfalia,Germany, and was not involved with the research. He said: “Drones are being used for an increasingly wide range of purposes and this study shows how they could make an important contribution to the emergency services, enabling AEDs to reach people suffering heart attacks more quickly. However, it is vitally important that, in every country, as many members of the public as possible know how to provide cardiopulmonary resuscitation and how to use defibrillators. Without this training, someone suffering an out-of-hospital cardiac arrest would still have to wait for the arrival of the emergency services, even if an AED is positioned nearby or arrives quickly by drone.”(ends)

[1] Abstract no: OA066, “Optimizing automated external defibrillator access using drones: a geospatial analysis in the Paris region” by Hillary Minka, Best abstracts session, Saturday 26 September, 11:00-12:30 hrs CEST, room 142.

Funding: This study received no funding.

Embargo: 00.01 hrs CEST on Friday 25 September 2026

Paris, France: The risk of death for patients treated in the emergency department increases by one per cent for every ten per cent increase in occupancy, according to research that will be presented at the European Emergency Medicine Congress. [1]

The researchers say their findings show how overcrowding brings a very real risk for patients and provides evidence for policy makers and hospital managers on prioritising emergency care. Although the study was based on UK hospitals, the researchers say that given the levels of overcrowding in hospitals around the world their findings may apply in many other countries.

The research was presented by Dr Ryan McHenry from the University of Glasgow, UK, and an emergency medicine doctor in the West of Scotland. He said: “Emergency department overcrowding is an increasing public health concern internationally, with evidence that long delays increase patient mortality. Crowding is also associated with poor patient and staff experiences.

“There is less evidence around how crowding itself might be associated with mortality. Our traditional measures of emergency department crowding were developed in a time where crowding was less of an issue, and these simply aren’t sufficient to describe the crisis that currently exists in emergency care.”

The study included 19,034 patients being treated at 134 hospital emergency departments in Wales, Northern Ireland and England over five different time periods in 2025.

Researchers compared data on patient deaths within 28 days of being treated in the emergency department with information on occupancy on the day they were seen in the department.

Occupancy is calculated by how many spaces, such as cubicles, the department has compared with how many patients were being treated. For example, a hospital with 50 cubicles and 50 patients is at 100% occupancy, with 40 patients it is at 80% occupancy, and with 60 patients it is at 120% occupancy. The study showed that, on average, emergency departments were operating at 175% occupancy.

Analysis of the data showed that for every ten per cent increase in occupancy, the risk of dying from any cause within 28 days increased by one per cent. At the levels of crowding experienced by departments in this study, this equates to hundreds of deaths a week.

Dr McHenry and his colleagues also looked at the impact of ‘corridor care’ where patients receive treatment in non-standard clinical spaces such as corridors. This was also linked to an increase in the risk of deaths, in line with the risk associated with the occupancy rate. However, researchers say occupancy rate is much easier to measure and record.

Dr McHenry said: “We found that increased crowding in emergency departments is associated with increased mortality for patients admitted to hospital. This is important because we know that emergency departments are now often very crowded, and reducing that crowding has the real potential to save lives. Overcrowding is a problem in many countries and, although there will be regional differences, this link between overcrowding and patient deaths is likely to hold true around the world.

“A major strength of this study is its size and geographic reach, with participation from 139 emergency departments from across the UK. We’ve worked with hundreds of collaborators, collecting data that otherwise would be impossible to bring together. This gives us a detailed and accurate view of how crowding and corridor care impact patients.

“Extrapolating the results of this study across the UK means that emergency department crowding could have contributed to 554 deaths a week during the study period, as compared to a situation where departments had one space for every patient. Although we cover the majority of the emergency departments in the UK, this was still a relatively small study, and the possible range of expected deaths is therefore large; we estimate anywhere between 33 and 1,083 excess deaths are plausible. Regardless, these numbers track similar estimates of harm from long waits and crowding, and demonstrate the harms associated with the crisis in emergency care. Further studies are needed to confirm these findings and find a more precise estimate of the harms from crowding.

“We are already engaging with governments to ensure this research feeds into health service policy. We now need to find solutions that work in tackling emergency department crowding.”

The researchers have used their results to create a risk calculator (www.uncorkedcalculator.com) where emergency department staff can understand the risks for patients when their department is overcrowded.

Dr Felix Lorang is a member of the EUSEM abstract selection committee. He is head of the emergency department at Klinikum Lippe, North Rhine-Westphalia, Germany, and was not involved in the research. He said: “Around the world, the need for emergency care is growing, while infrastructure is failing to keep pace. Many emergency departments are operating far beyond capacity, and the ‘exit block’ — when patients are stuck in the emergency department because no inpatient ward beds are available — places an even greater burden on these emergency departments. This makes it harder for doctors and nurses to deliver the treatment patients need, or even the minimum treatment required to prevent further harm.

“This research makes it unmistakably clear to all of us — patients, medical professionals, and hospital managers alike — that overcrowding and corridor care mean many emergency patients will not survive.

“These findings can help hospitals understand the true impact of overcrowding in emergency departments. Understaffed and inadequately resourced emergency departments are, in themselves, an independent and dangerous health risk. But these results are especially critical for governments, politicians, and health services, because saving lives in emergency care is achievable — by preventing overcrowding, through sufficient staffing and through emergency departments that are adequately planned and equipped.”(ends)

[1] Abstract no: OA068, “The association between emergency department occupancy and mortality: a multi-centre prospective cohort study” by Ryan McHenry, Best abstracts session, Saturday 26 September, 11-12:30 hrs CEST, room 142.Funding: The UK Royal College of Emergency Medicine. The researchers also acknowledge all the time given voluntarily by collaborators across the UK to make this study possible.

Embargo: 00.01 hrs CEST on Friday 25 September 2026

Paris, France: Seventy-five percent of workers in emergency medical departments and services have witnessed violence in the past year, according to a survey of over 1,300 health professionals in 81 countries worldwide.

In a special session at the European Emergency Medicine Congress today (Friday), Luis Garcia Castrillo, a professor in emergency medicine, now retired, at the Hospital Marqués de Valdecilla, Santander, Spain, said that while patients and their friends or relatives were the main perpetrators, often because of alcohol or drug consumption, overcrowding in emergency medical departments was an equally important contributor to the violence.

Prof. Castrillo said: “Workplace violence not only jeopardises the physical and mental health of healthcare professionals but also negatively impacts the quality of care they provide. The survey reveals that 45.8% of respondents thought that the quality of care was diminished as a result of the violence they encountered.”

The international, online survey, conducted by the EUSEM Emergency Medicine Day Working Group, received responses from 1,306 healthcare providers in 81 countries between May and June 2026. A paper is published in the European Journal of Emergency Medicine (EJEM) at the same time as its presentation to the Congress [2].

It found that 75.5% of respondents had witnessed violence in their workplaces in the previous year, 68.8% had experienced psychological harm and 40.3% had experienced physical harm.

Verbal aggression was the most common form of violence (87.8%), followed by physical assault (42.3%), property damage (26.4%), sexual harassment (14.6%), race-related violence (14.5%), armed conflict (4.5%), weapon-related incidents (4.1%), sexual assault (3.5%), cyber harassment (3.1%), and firearms incidents (2.9%). Patients were the principal perpetrators (67.6%), followed by relatives or friends (44.1%). Intoxicated patients or visitors accounted for 44% and psychiatric patients for 35.2%.

Nearly half of the respondents (48.3%) thought workplace violence had worsened over the previous five years, and they perceived violent patients as one of the greatest occupational threats, second only to the risk of infection. Only half (51.1%) had received formal violence prevention training, 38.6% reported no formal training, 57.3% had access to psychosocial support after violent incidents, whereas 27.1% had no access. Women were more likely to report psychological victimisation than men: 72.2% versus 40.4%.

Dr Roberta Petrino, director of the Emergency Department at Ente Ospedaliero Cantonale, Lugano, Switzerland, co-chaired the EUSEM Congress session and is the first author of the EJEM paper. She said: “I would like to underline that the major problem for women working in emergency medicine is the verbal violence; this could be insults, sexual references, gender-related harassment and discrimination. Women emergency workers are subjected to this far more than men, and it has mainly psychological consequences. Respondents to the survey wanted psychological support, and the problem of violence to be addressed through prevention and better safety processes.

“Another important point is the perception of scarce preparation to tackle the problem of violence; respondents thought the emergency services were more prepared for a mass casualty event than for everyday violence.”

Prof. Castrillo, Dr Petrino and the other authors of the report issued a call to all providers of emergency services – pre-hospital services and emergency medical departments – to consider ways to reduce the possible triggers for violence.

Dr Petrino said: “Prolonged waiting times, limited resources and high emotional stress all escalate tensions among patients, relatives and healthcare professionals. This needs to be tackled through organisational interventions. Hospital managers should improve the internal organisation of the hospital so as to reduce overcrowding, for instance, by providing good, well-designed spaces that are well-staffed, and setting up policies in the wards to facilitate patients transferring to them quickly from emergency departments. This would allow emergency departments to improve patient flow. Managers should consider specific education about how to de-escalate situations and how to communicate well, and they should provide safety systems such as video cameras and security personnel.

“Finally, the question should be addressed about violence against healthcare providers in war zones: a large number of Ukrainian doctors, 258, responded to our survey.”

A strength of the study is the large number of responses from so many countries, although there was more participation from some countries than others, which could have introduced bias in the responses. Other limitations include the voluntary and self-reported nature of the survey, which could have introduced bias in the selection and responses of the participants; and the sample size was reduced as about 40% of questionnaires were excluded due to missing or incomplete data.(ends)

[1] “How our colleagues feel about: results from the survey“, presented in the ‘No safe space for emergency medicine teams? End violence everywhere’ session by Luis Garcia-Castrillo, Friday 25 September, 15.45-17.15 hrs CEST, Amphitheatre. https://eusem.floq.live/event/eusem-2026/search?objectClass=timeslot&objectId=69aab6a8fc86e8dca2720cda&type=detail

[2] “Workplace violence and safety perception in emergency medicine system: the Emergency Medicine Day International survey across 81 countries” by Roberta Petrino et al., European Journal of Emergency Medicine doi: 10.1097/MEJ.0000000000001375

Contact Emma Mason if you would like an embargoed copy of the paper before publication.

Funding: The study received no external funding.

Skopje, North Macedonia – The Minister of Health of North Macedonia, Sasho Klekovski, has reaffirmed the government's commitment to strengthening emergency medical services following a high-level meeting with representatives of the European and Macedonian emergency medicine communities.

The meeting brought together leaders from the European Society for Emergency Medicine (EUSEM) and the newly established Macedonian Association for Emergency Medicine (MZUM). Delegations were led by EUSEM President Dr Robert Leach and MZUM President Dr Vesna Krstevska.

During the discussions, Minister Klekovski outlined a series of ambitious reforms aimed at modernising North Macedonia's emergency care system and improving access to timely, high-quality emergency medical services across the country.

Among the key initiatives presented were plans to establish the Skopje Emergency Medical Service as a separate organisational unit, distinct from the existing Skopje Health Centre structure. The reform programme also envisages the introduction of a modern emergency medical services model incorporating paramedics, bringing North Macedonia closer to internationally recognised standards of emergency care.

The Ministry further announced plans for a major investment in emergency medical transport infrastructure, including the procurement of 100 new emergency vehicles, followed by an additional 50 vehicles in a second phase. These investments are intended to strengthen response capacity and improve patient access to emergency services throughout the country.

Another priority highlighted during the meeting was the reorganisation of the Emergency Centre at the Mother Teresa Clinical Centre in Skopje. The proposed changes aim to enhance patient flow, improve coordination of emergency services and support more effective delivery of acute care.

Minister Klekovski also noted that the Ministry is examining international best practices as part of the reform process. This includes studying the Slovenian model, which features a national dispatch centre, and the Romanian model, known for its specialised emergency medical services. Consideration is also being given to the development of services that currently remain outside the formal emergency care system, including mountain rescue capabilities.

Representatives of EUSEM expressed their willingness to support the ongoing reform efforts and welcomed the establishment of the Macedonian Association for Emergency Medicine. The meeting highlighted opportunities for future cooperation in areas such as professional development, standards of care, training and system development.

Commenting on the discussions, Minister Klekovski thanked both organisations for their engagement and commitment to advancing emergency medicine in North Macedonia.

"Emergency medicine is the front line of the health system, and these reforms are measured in saved lives," he said.

The meeting marks an important step in strengthening collaboration between national and European emergency medicine leaders and demonstrates a shared commitment to improving emergency care for patients across North Macedonia.

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