Midland, TX Medical Drones

To help rural hospitals close to Midland Texas.

The Bid

Rural hospitals are an important part of a community, yet around the nation many rural hospitals struggle with sustainability and are closing down. Midland Texas is taking the next step in keeping these hospitals, and with them the communities they serve, afloat.
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Our Solution

Our team has decided to implement medical drones into the current hospital network as a solution to the problems rural hospitals are faced with.


We believe there are major benefits medical drones can bring through their integration, their speed and range, their viability to carry out regular hospital work, their safety, and their fiscal properties.

Integration

Rural hospitals have been facing serious struggles, low occupancy rates, and a lack of professionals in rural areas especially have a drastic toll on keeping these hospitals sustainable. Yet there exists innovative technology that can bring with it sustainability for these hospitals. Medical drones could be the answer to many of these problems.


Modern Healthcare has an article that goes over the struggles facing rural hospitals, and in it mentions how some rural hospitals must link with larger regional hospitals to continue their services (Demko). Of course, while this link lets them continue their services, the distance creates a decrease in the quality of their services. Medical drones can give the best of both worlds in this situation, create a powerful network between the regional or central hub hospitals, and still have quality care provided by the rural hospitals. One of the strongest and most obvious ways medical drones can do this is by the transportation of medicine. Rare and expensive medicine especially could be transported to local hospitals as necessary in an efficient manner. Therefore easing the burden on these local hospitals to keep such medicine in supply. Snake bites for example are a very real threat, but relatively rare occurrence, so the central hub could store the antivenin until a local hospital has a victim, and quickly deliver it with wider range and speed than available with an ambulance.

DHL to Deliver Medicine via Drone

Medical drones would also help keep professional service alive. Both emergency and regular medical appointments could still be treated with the use of a drone network. For example, drones would be able to perform remote checkups for people in their local hospital or even in their comfort of their own home. The viability of this, especially the transportation of blood and other organic materials is explained further in viability. Emergency services, which can be crucial for survival, can also be strengthened. A Forbes article mentions a drone that carries a defibrillator (Husten). Such a device could directly be sent to anyone as soon as the emergency call is made. This would also give the ambulance more time to arrive and proceed with the rest of the patient’s necessary care, but the speedy start the drone has could be the difference in life saving minutes.


Georgia governor Nathan Deal has actually created the Rural Hospital Stabilization Committee, trying to solve this same kind of problem. According to their website, they want to add smaller critical access care hospitals and buy more ambulances (Rural Hospital Stabilization Committee). Both of these do have the potential to help but neither will be as efficient as drones. Modern Healthcare reports that rural hospitals have an occupancy rate of about 37%, and if more critical access care hospitals are created, the market could easily be spread too thin causing these hospitals to go out of business (Demko). Drones on the other hand would not expand the existing hospital web, but would instead strengthen the web that already exists.

More information on Integration

Modern Healthcare

Discusses the idea of a central hub and goes over the struggles facing rural hospitals.

http://www.modernhealthcare.com/article/20150516/MAGAZINE/305169959


Nathan Deal's Plan

The Rural Hospital Stabilization Committee's report.

https://gov.georgia.gov/press-releases/2015-02-23/deal-releases-rural-hospital-stabilization-committee-report

Range and Speed

The implementation of these drones into the medical system here in Midland Texas will be able to save lives through increased coverage and quicker response time, relative to current methods. The use of these drones in medical deliveries enhances the total coverage of medical systems through enhanced range in relation to emergency medical services, or EMS. As seen in the figures put out by the Texas Tech University Health Sciences Center, emergency medical service centers only have immediate coverage of a 35 mile diameter (An Assessment). These figures show that there is a lack of coverage within the Midland region, leaving many places under served or unaided as a whole.

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In order to alleviate this problem, the current drone technology, allows for a much larger range of flight while carrying a load. Shannon Lee from Healthcare Technology Consultant describes the benefits of increased flight time due to long lasting batteries and smoother, brushless motors that can ensure flight for up to an hour (Lee). These drones can fly while carrying a payload with a range of up to 60 miles, as stated in an article about the future of medical drones put out by Mayo Clinic (Medical Drones).

Drone: OnyxStar Hydra-12 with 9kg of payload - heavy lifting

The implementation of these drones will result in response times and speeds which are currently unmatched my any ground technology. Due to the limited number of ambulances per county, as well as the many less than ideal road condition which exist in Midland and the West Texas area, ambulances have hazardously slow response times. Leslie Waghorn, from the Texas A&M Health Sciences Center, states that receiving treatment within the first hour following can greatly increase the mortality rate following an accident (Waghorn). Dr. Jim Luecke, one of the family practice doctors working in West Texas said in an in interview with Emily Ramshaw that frequently when an accident occurs on a ranch, this full hour will be spent waiting on the ambulance to arrive (Ramshaw). State Representative Joe Heflin details a time when it took an ambulance an hour and 15 minutes to reach a man having a heart attack, who survived the initial attack but later died because his heart was so damaged by the delay (Ramshaw).This figure below shows simply how few and far between the main trauma centers in Texas are, explaining the long lag time to service.

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In order to combat this slow response time, drones have been created which can quickly deliver necessities to accident scenes, potentially saving lives. A drone has been created that can fly up to speeds of 60 miles per hour, carrying a defibrillator and flying 60 total miles, according to Michelle Starr from cnet.com (Starr). These drones, as said by Mark Prigg from dailymail, are able to get a defibrillator to a patient within a 4.6 square mile radius within a minute, saving lives of those near as well as far (Prigg).

More information on Range and Speed

Texas Tech University Health Sciences Center

Discusses a number of range issues and stories of problems with current ambulance program.

https://www.ttuhsc.edu/ruralhealth/newsletter/EMS%20Report%20pdf%20format.pdf


Daily Mail

Discusses ambulance drone capabilities.

http://www.dailymail.co.uk/sciencetech/article-2811851/The-ambulance-drone-save-life-Flying-defibrillator-reach-speeds-60mph.html

Project Viability

When integrated with existing rural emergency medical services, unmanned aerial systems present life-saving solutions. With increased range and decreased response time, these drones are able to effectively supplement existing services and fill gaps in coverage. Outfitted with AED’s and refrigeration systems for blood and organ transit, these drones can provide rapid, consistent access to necessary medical care in rural areas.

Automated External Defibrillators (AED’s) are an essential first step in heart attack treatment, providing an electric shock to jolt the heart back into natural rhythm. Rapid treatment is crucial, as the chance of surviving a heart attack drops by 10% every minute (NHLBI). Typically, AED’s are less available in rural areas (AHA). Coupled with greater incidences of heart diseases and other chronic illness, there is a greater need than ever for access to these devices (O'Connor and Wellenius). Unfortunately, with long ambulance response times and gaps in emergency coverage, access in rural areas is greatly lacking.

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Due to long distances and poor road conditions, rural ambulance response times are slow at best (Volz). Drones offer a solution, providing faster response times through straight line flight speeds of up to 60mph at altitudes of 200-400 feet (Pilkington). The Delft University of Technology in the Netherlands has shown a promising proof of concept for AED delivery. Studies related to the program have shown that a drone network could increase heart attack survival rates from 8% to 80% (TU Delft). The studies also found that only 20% of untrained users were able to correctly operate the AED, but, via instructions through an integrated webcam, this rate increased to 90% (Starr).

TU Delft - Ambulance Drone
Drones have shown promise in another area of emergency response: blood delivery. To reduce trauma deaths, (our) drones could transport blood units to remote hospitals and trauma sites. Very few ambulance and even life flight services currently perform blood transfusions at accident sites and in transit to hospitals (VUMC). Studies have shown that short-term survival rates increase when blood transfusions are performed in transit (Brown)(Weaver). Drones could transport blood units to trauma sites so that ambulances and helicopters don’t have to continuously carry large amounts and various types of blood. In addition, drones could supplement rural hospital blood supplies by transferring units from larger hospitals.
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Drones could also perform non-emergency delivery time-sensitive tissues, such as blood and organs, more effectively than traditional methods between urban and remote medical centers. A proof of concept study from Johns Hopkins showed that drones could safely transport laboratory samples of blood without damaging them, important in rural areas with particularly rough roads, or great distances from large labs (JHU&HS). Traditional medical couriers, especially in rural areas, can damage sensitive samples when travelling over large bumps, or sitting during long transits, where drones could quickly and smoothly transport the blood. Drones could quickly and safely transport delicate organs for transplant, such as hearts and livers, where ground transport can be lengthy, and air transport by helicopter very expensive (Babu).
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ER Drone - An Intelligent Emergency Response Drone

Project Safety

Safety is always a concern when it comes to the medical field and adding in drones to medical transportation is no different. By delivering some vital health care goods by drone, transportation methods can be made safer, especially in the areas of time sensitive deliveries and crashes. In addition, our drones will be FAA compliant, keeping air travel safe.


From 1992 to 2011 there were an estimated 4,500 reported crashes involving an ambulance. While most of these (65%) only resulted in property damage, 34% resulted in injuries. (“NHTSA”)

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By using drones to deliver non-emergency and emergency supplies, the amount of ambulances on the road can be lessened, allowing for fewer accidents. Considering that a single crash can render a rural EMS ineffective and leave urban EMS systems with fewer vehicles with which to respond to emergencies, cutting back on the number of non-emergency ambulances through the use of drones can make travel safer and result in fewer crashes. (Levick)



In addition, biohazard and tissue delivery, especially those that are time sensitive can be sped up with drones. Using ambulances to transport these resources can be slow due to traffic in urban areas where the major hospitals are. Since drones can travel in a straight line unaffected by ground traffic, it beats out the ambulance’s time.



Helicopters, while safer than ambulances since there is less traffic in the skies, are not immune to accidents and can be very costly to maintain and use. According to a report by the National Transportation Safety Board, “Medical helicopters have a higher ratio of accidents to number of flight hours than other types of aviation.” (Noonan). These problems arise due to weather and maintenance issues. In addition, the average cost of maintaining a few medical helicopters will be greater than the cost to maintain drones which is approximately $20-50 per unit per flight. (Armus)

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However, helicopters can be quick to send out time sensitive deliveries, but can be very costly. As stated before, the cost to maintain a helicopter is much higher compared to that of a drone, the latter of which can deliver time sensitive materials just as fast as medical helicopters. According to an article by ABC News, urban areas where the distances are short, ambulances are often the faster and more cost effective way to go. Since drones are faster and cheaper than ambulances, they will be a great addition to medical transportation.



Regarding the FAA, there are rules governing the use of drones, dictating where they can and can’t fly. This includes airports and airspace above 400 feet. These rules are in place to keep these drones from interfering with the flight of larger aircraft. The image below shows how the airspace is cut up and shared between airplanes and drones. (Mac, “DOT”)

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In addition, there are proposed rules governing drones regarding line of sight. These rules in rural areas mean that drones can be operated beyond line of sight and within line of sight in urban areas. (“Press”) However, exemptions exist for first responders under a special area of Section 333 exemptions. (“Fact”) These exemptions will allow the program to quickly start up and remain under FAA guidance. These rules are still under review and should be finalized in early to mid 2016. (William, Dillow).

More Information on Safety

"NHTSA and Ground Ambulance Crashes.“

An analysis of Ambulance Crashes from the years 1992-2011.

http://www.ems.gov/safety-gacd.htm


"Fact Sheet – Unmanned Aircraft Systems (UAS)." FAA.

Facts regarding drone use as set out by the Federal Aviation Administration.

http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=18297

Project Cost

Continuing from what my associate, Ms. White, has written, courier drones for the delivery of emergency and non-emergency medical supplies will be a cost effective endeavor. A courier drone is immensely cheaper than a medical helicopter when it comes to the task. Second, the operation of a courier drone is much more cost effective then a medical helicopter, resulting in a tidy return of investment. For now, let us take a closer look at how much these drones will cost the city of Midland.


With drones on the rise as a consumer commodity, pricing is a question that is ultimately asked. The price of the proposed drone for usage in this project, the Microdrones’ md4-1000, is variable according to various sources. According to an article in the international business times, the courier drone German logistics Company DHL is currently planning for future use is estimated to cost forty thousand euros[approximately forty-three thousand USD](Russon). Whereas in an interview with Michael Dionisi, a representative from the American branch of Microdrones, Avyon, the md4-1000 was quoted at thirty thousand USD(Dionisi). With these numbers in mind, we can make a direct comparison to a model of helicopter, the Sikorsky S-76C++, which is priced at 6.5 million USD according to business air, a helicopter seller(Business). Finding an average price between the two quotes, the ratio of courier drones to hospital helicopter price wise is one hundred eighty three to one. Or for a more compact comparison, one hundred fifty to one.

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Furthermore, this comparison does not take into account the amount of salary paid to the pilot of said helicopter.


Now, how much more cost effective is a courier drone in its operation versus a medical helicopter? Thanks to the help of the following sources, relevant numbers were acquired. After some calculations, I’ve come up with these results. When it comes to average amount of EMT calls in Midland, Texas per year, about a sixth require the use of a helicopter which could be replaced with a drone. This amounts to, according to a 2013 survey by EMT world, three point five thousand calls(Roche). According to an article by ABC, the price of a life saved with a helicopter, not to put a monetary value on human life, is calculated at an average of one million dollars(Noonan). An average cost of ER treatment per person per year is fifteen thousand according to a survey by Johns Hopkins School of Medicine(Velopulos). Using these numbers and those mentioned previous, I calculated the money saved by implementing these drones. Implementing this system of drones, looks to save about 1.6 billion dollars. When compared to current costs, this amounts to about ninety-five percent saved in funds. As shown by my calculations, which are attached in a PDF form, should they require further scrutiny, courier drones are an immensely more cost effective option when compared to helicopters.

Emt_calls=10500/6;

Cost_Life=1000000;

ER_cost=15000;

Cost_drone=36500;

Cost_heli=6500000;

Pilot_pay=82000;

Cost_Lifed=Cost_drone+ER_cost;

Cost_Lifeh_yr=Cost_Life*Emt_calls;

Cost_Lifed_yr=Cost_Lifed*Emt_calls;

MoneySaved=Cost_Lifeh_yr-Cost_Lifed_yr;

PercentSaved=MoneySaved/Cost_Lifeh_yr*100;

formatSpec='Percent of money saved with drones is %4.2f percent\n';

fprintf(formatSpec,PercentSaved)

Cost_Lifeh_yr

Cost_Lifed_yr

MoneySaved

Cost_Lifed


Percent of money saved with drones is 94.85 percent


Cost_Lifeh_yr = 1.7500e+09


Cost_Lifed_yr = 90125000


MoneySaved = 1.6599e+09


Cost_Lifed = 51500



Published with MATLAB® R2015a

(Note, all amounts are in current USD.)

Executive Summary

The integration of medical drones clearly has its advantages and is a feasible option to solve the crisis rural hospitals face. The technology for medical drones is here and Midland Texas could be the next city to take the next step.

As previously stated, when compared to the current methods of ambulances, unmanned delivery of medical supplies and equipment through use of drones creates enhanced coverage and response time.

In addition, the high performance of drones in a medical environment has real-world medical benefits. Where there is limited access to AED’s, such as rural areas, drones can provide a crucial quick response.

When transporting delicate tissue such as blood samples or organs, drones can provide a quicker, smoother ride for both emergency and non-emergency delivery.

By delivering some vital health care goods by drone, transportation methods can be made safer than ambulances and helicopters, especially in the areas of time sensitive delivery costs and crash records. In addition, our drones will be FAA compliant, keeping air travel safe.

Finally, the costs speak for themselves, at a billion saved over a year, including the purchase of said drones, which should be more than their maintenance over the years, and at a over ninety percent reduction in costs. By bringing medical drones into the fray, not only will Midland save money, but through those extra funds, can they save even more lives.

Sources

Integration:

Demko, P. (2015, May 16). As rural hospitals struggle, solutions sought to preserve healthcare access. Retrieved from Modern Health Care: http://www.modernhealthcare.com/article/20150516/MAGAZINE/305169959

Husten, L. (2014, October 29). Grad Student Invents Flying Ambulance Drone To Deliver Emergency Shocks. Retrieved from Forbes: http://www.forbes.com/sites/larryhusten/2014/10/29/grad-student-invents-flying-ambulance-drone-to-deliver-emergency-shocks/

Rural Hospital Stabilization Committee. (2015, February 23). Rural Hospital Stabilization Committee Final Report to Governor. Retrieved from Georgia: https://gov.georgia.gov/sites/gov.georgia.gov/files/related_files/press_release/Rural%20Hospital%20Stabilization%20Committee%20Report%20022315%20FINAL.pdf


Range and Speed:

"An Assessment of Rural West Texas Emergency Medical Services (EMS)." Texas Tech University Health Sciences Center. N.p., n.d. Web:

https://www.ttuhsc.edu/ruralhealth/newsletter/EMS%20Report%20pdf%20format.pdf

Lee, Shannon D. "Are Drones the Future of Medical Air Transport?" HIT Consultant. HIT Consultant Media, 07 Apr. 2015. Web:

http://hitconsultant.net/2015/04/08/drones-medical-transport-future/

"Medical Drones Poised to Take Off." Mayo Clinic. Mayo Foundation for Medical Education and Research, n.d. Web:

http://www.mayoclinic.org/medical-professionals/clinical-updates/trauma/medical-drones-poised-to-take-off

Prigg, Mark. "The Ambulance Drone That Could Save Your Life." Daily Mail. Associated Newspapers, 29 Oct. 2014. Web:

http://www.dailymail.co.uk/sciencetech/article-2811851/The-ambulance-drone-save-life-Flying-defibrillator-reach-speeds-60mph.html

Ramshaw, Emily. "Little Trauma Care in Rural Texas." The Texas Tribune. N.p., 5 Jan. 2010. Web:

http://www.texastribune.org/2010/01/05/little-trauma-care-in-rural-texas/

Starr, Michelle. "Ambulance Drone Delivers Help to Heart Attack Victims." CNET. N.p., 28 Oct. 2014. Web:

http://www.cnet.com/news/ambulance-drone-delivers-help-to-heart-attack-victims/

Waghorn, Leslie. "New Research Shows Golden Hour Trauma Care Saves Lives on the Battlefield." Texas A&M Health Science Center. N.p., 15 Oct. 2015. Web:

https://news.tamhsc.edu/?post=new-research-shows-golden-hour-trauma-care-saves-lives-on-the-battlefield


Viability:

“Rural and Community Access to Emergency Devices”, American Heart Association Advocacy Department, Web 2013, Accessed 11/30/15 http://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_301646.pdf

O'Connor, A and Wellenius, G “Rural-urban disparities in the prevalence of diabetes and coronary heart disease.” National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health, Department of Health and Human Services , Web October 2012, Accessed 11/30/15 http://www.ncbi.nlm.nih.gov/pubmed/22922043

Automated External Defibrillator National Heart, Blood, and Lung Institute, National Institutes of Health, Department of Health and Human Services, Web, Updated 12/2/2011, Accessed 11/30/15 https://www.nhlbi.nih.gov/health/health-topics/topics/aed

Volz, Richard A, “OPTIMUM AMBULANCE LOCATION IN SEMI-RURAL AREAS”, Highway Safety Research Institute, University of Michigan, Published 1970, Accessed 11/30/15 http://deepblue.lib.umich.edu/bitstream/handle/2027.42/1396/14904.0001.001.pdf?sequence=2

Pilkington, Ed, “Amazon proposes drones-only airspace to facilitate high-speed delivery”, Guardian News and Media, Web 7/28/2015, Accessed 11/30/15 http://www.theguardian.com/technology/2015/jul/28/amazon-autonomous-drones-only-airspace-package-delivery

“TU Delft's ambulance drone drastically increases chances of survival of cardiac arrest patients”, Delft University of Technology, Web 10/27/2015, Accessed 11/30/2015 http://www.tudelft.nl/en/current/latest-news/article/detail/ambulance-drone-tu-delft-vergroot-overlevingskans-bij-hartstilstand-drastisch/

Starr, Michelle, “Ambulance drone delivers help to heart attack victims “, CNET, CBS Interactive, Web 10/28/2015, Accessed 11/30/2015 http://www.cnet.com/news/ambulance-drone-delivers-help-to-heart-attack-victims/

“Proof-of-Concept Study Shows Successful Transport of Blood Samples with Small Drones “,The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System, Web 7/29/2015, Accessed 11/30/2015 http://www.hopkinsmedicine.org/news/media/releases/proof_of_concept_study_shows_successful_transport_of_blood_samples_with_small_drones

Babu, Gireesh, “Fortis to test drones to transport organs for transplantation”, Business Standard, Web 11/15/2015, Accessed 11/30/2015 http://www.business-standard.com/article/companies/fortis-to-test-drones-to-transport-organs-for-transplantation-115111500281_1.html

“LifeFlight’s blood transfusion practices affirmed by new study”, Vanderbilt University Medical Center, Web 4/3/2015, Accessed 11/30/2015 http://news.vanderbilt.edu/2015/03/lifeflight%E2%80%99s-blood-transfusion-practices-affirmed-by-new-study/

Brown, Joshua B., et al, “Pre-Trauma Center Red Blood Cell Transfusion Is Associated with Improved Early Outcomes in Air Medical Trauma Patients”, Journal of the American College of Surgeons, Web 1/23/2015, Accessed 11/30/2015

Weaver, AE, et al, “The introduction of on-scene blood transfusion in a civilian physician-led pre-hospital trauma service”, Scandinavian Journal of Trauma, Resuscitation, and Emergency Medicine, Web 5/28/2013, Accessed 11/30/2015 http://www.sjtrem.com/content/21/S1/S27


“National Average EMS Response Times for Fatal Crashes in 2002” US DOT, 2004 http://safety.transportation.org/htmlguides/rural/section03.htm

Pathologist Timothy Amukele, left, teamed with Robert Chalmers and other engineers to create a drone courier system that transports blood to diagnostic laboratories. Johns Hopkins Medicine, 2015

Ploughman, Lars, “Emergency delivery of human organs for transplant?” elevation2, 1/9/2014, http://elevation2.com/2014/01/emergency-delivery-of-human-organs-for-transplant/


Safety:

Armus, Teo. "Emergency Drones Could Serve as Airdrop Medical Responders." PSFK. N.p., 24 June 2015. Web. 07 Dec. 2015. <http://www.psfk.com/2015/06/emergency-drones-medical-responders-skyprowler-drones-epi-pen-ambulance-krossblade-aerospace-systems.html>.

Cryk, Jason. Scene of a head-on crash between minivan and ambulance on Queen’s Line east of Tilbury, Ont. in Chatham-Kent on July 3, 2013. Digital image. The Windsor Star. N.p., n.d. Web. 8 Dec. 2015. <http://windsorstar.com/news/local-news/chatham-kent-police-on-scene-after-crash-between-minivan-and-ambulance>.

Dillow, Clay. "With New Rules, the FAA and Drone Industry Make up." Fortune. Fortune, 18 Feb. 2015. Web. 01 Dec. 2015. <http://fortune.com/2015/02/18/faa-drone-rules-proposal/>.

"DOT and FAA Propose New Rules for Small Unmanned Aircraft Systems." FAA. FAA, 15 Feb. 2015. Web. 01 Dec. 2015. <http://www.faa.gov/news/press_releases/news_story.cfm?newsId=18295>.

"Fact Sheet – Unmanned Aircraft Systems (UAS)." FAA. FAA, 15 Feb. 2015. Web. 01 Dec. 2015. <http://www.faa.gov/news/fact_sheets/news_story.cfm?newsId=18297>.

Helicopter Maintenance Services. Digital image. Helicopter Services, Inc.N.p., n.d. Web. 08 Dec. 2015. <http://www.heliserv.com/helicopter-services/maintenance/>.

Levick, Nadine. "EMS World EXPO." (2012): n. pag. Http://www.emssafetyfoundation.org/, 29 Oct. 2012. Web. 1 Dec. 2015. <http://www.emssafetyfoundation.org/2012EMSExpoNewOrleansHO.pdf>.

Mac, Ryan. "Amazon Proposes Drone Highway As It Readies For Flying Package Delivery." Forbes. Forbes Magazine, 28 July 2015. Web and Digital Image. 01 Dec. 2015. <http://www.forbes.com/sites/ryanmac/2015/07/28/amazon-proposes-drone-highway-as-it-readies-for-flying-package-delivery/>.

"NHTSA and Ground Ambulance Crashes.“ NHTSA, Apr. 2014. Web. 01 Dec. 2015. <http://www.ems.gov/safety-gacd.htm>.

Noonan, Jessica, Dr.. "Medical Helicopters: Worth the Cost, Risk?" ABC News. ABC News Network, 17 Apr. 2012. Web. 07 Dec. 2015. <http://abcnews.go.com/Health/medical-helicopters-worth-cost-risk/story?id=16155993>.

"Press Release – FAA-Industry Initiative Will Expand Small UAS Horizons." FAA. FAA, 6 May 2015. Web. 01 Dec. 2015. <https://www.faa.gov/news/press_releases/news_story.cfm?newsId=18756&cid=TW308>.

William, O'Connor V., and Carr J. Christopher. "Drones: FAA Announces Pathfinder Program to Explore BVLOS and Urban Drone Operations." (n.d.): n. pag. Morrison/Foerster, 22 May 2015. Web. 1 Dec. 2015. <http://www.mofo.com/~/media/Files/ClientAlert/2015/05/150522DroneFAAPathfinder.pdf>


Cost:

Business Air. Business Air. Web. 7 December 2015.

Dionisi, Michael. “md4-1000.” Message to Christian Barrientes 1 Dec 2015. E-mail.

“md4-1000.” Microdrones. Microdrones, n.d. Web. 7 December 2015.

Noonan, Jessica. “Medical Helicopters: Worth the Cost, Risk?” ABC 17 April 2012: ABC News Medical Unit. Print.

Roche, Kevin. Friszell-Neroulas, Elizabeth. “2013 National Run Survey.” EMT World, 2013. PDF File.

Russon, Mary-Ann. “DHL To Launch 'Parcelcopter' Medicine Drone Delivery Service to Remote German Island.” International Business Times 25 September 2014: Technology. Print.

Velopulos, Catherine G. “National cost of trauma care by payer status.” Journal of Surgical Research 184.1 (2013): 444-449. Web. 7 Dec. 2015.