Sometimes the balance between life and death depends on being in the right place at the right time – with the right equipment.
Ask someone who has suffered a sudden cardiac arrest (SCA) - a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs, and chances of survival are extremely slim if the person is not treated within minutes.
In such cases early defibrillation is the only treatment proven that can restore a normal heart rhythm and save a person’s life.
“When used on a victim of SCA, an automated external defibrillator (AED) can administer a lifesaving electric shock that restores the heart’s rhythm to normal,” said Bryan Bonnet, a student at Stevens Institute of Technology.
Bonnet ’15, who graduates from Stevens this spring with a bachelor’s in computer engineering and a master’s in systems engineering, was recently awarded the Novartis Science Scholarship for independent scientific research.
Bonnet’s research project – which he is conducting with Dr. Jose Ramirez Marquez, associate professor & director of the engineering management division at the School of Systems and Enterprises, and another Stevens student, Keith Krauss - is on the Optimization of public-access AED deployment programs for the city of Hoboken.
“Survival rate of cardiac arrest is very low if there is no help within ten minutes,” said Bonnet. Early defibrillation, he says, is key in the “Chain of Survival” for treating SCA patients.
Studies have shown that placing AED devices in out-of-hospital environments - locations where people with limited or no training can use these devices on themselves, or on others, prior to the arrival of emergency responders, has the potential to reduce the time-to-shock, which increases patient survival rates.
In the urban landscape, the challenge, Bonnet said, is being able to identify optimal public-access locations that can minimize cost and maximize survival rate.
Bonnet’s research study uses a three-step approach – optimization, simulation and visualization – to identify potential locations that can be sponsored to provide and secure public-access AEDs in Hoboken.
Based on historical data obtained from the Hoboken Volunteer Ambulance Corps on cardiac-related call locations and timings, using mathematical algorithms, the team developed optimization models that maximize coverage of geospatial demand (where and when do cardiac calls occur), maximize temporal availability of deployed AEDs (where can AED’s be placed to reach the demand areas) and minimize number of deployed AEDs (cost-efficient).
The team then created simulations to come up with best potential configurations based in terms of time-to-retrieve the nearest available AED – which is used as an estimate for probability of survival.
Finally, the results of the optimization and simulation were visualized using a web-based user interface.
“The novelty of this study lies in the implementation of an interactive tool which allows a decision-maker to change parameters and observe effects on coverage and cost, ” said Dr. Ramirez-Marquez.
According to Bonnet, the study is not just applicable to healthcare systems. These models can be used by cities to build efficiencies in all of their systems – financial, defense, disaster recovery and more.
“In the long run, informed decisions for all large-scale systems will be based on the availability of information and the ability of decision-makers to manipulate this information in real-time to reduce risk and make effective choices, ” said Dr. Ramirez-Marquez.
For Bonnet, the next step is designing an ambulance location program in Guadalajara, Mexico.
“Healthcare has been my focus from an early age and I want to apply my computer and systems engineering knowledge to create models and tools that can address larger urban environments and make an impact on the global healthcare delivery system.“
Top photo: Visualization map for optimal AED locations in Hoboken
Second left photo: Stevens student Bryan Bonnet