A first-of-its-kind study exploring how airborne drones can help improve heart attack survival rates is running in rural James City County.
The program, a partnership between the county and Virginia Commonwealth University in collaboration with Duke University, is available in the Toano area and in Forsyth County, N.C. It equips a drone with an automated external defibrillator, or AED, which can fly to the scene of a heart attack and speed up lifesaving care.
Dr. Joseph Ornato of VCU is one of the people leading the study. He chaired the university’s department of emergency medicine for 23 years and has spent decades in emergency cardiac care. He worked closely with organizations such as the American Heart Association to develop techniques and tools to improve outcomes for people having heart attacks outside of hospitals.
For the more than 350,000 people who suffer a heart attack outside of the hospital each year in the United States, the time it takes for help to arrive can mean life or death. Ornato said about 10% of people survive, and every minute that passes without care the odds drop by 10%.
For those living in extremely rural areas, that figure drops to “almost zero,” Ornato said.
But on-the-ground response time, Ornato said, has largely hit a wall. Emergency medical vehicles can only go so fast in an urban or suburban setting, and take on average about eight minutes to reach a patient. After medics unload and prepare equipment, it’s usually minute 11 before a patient receives their first defibrillation.
“Hence the low survival,” Ornato said.
That’s where drones could make a difference. The program launched in Forsyth late last year and started up in James City on Aug. 1, where Ornato’s former medical resident at VCU, Dr. Amir Louka, is the fire department’s EMS medical director. It is using one drone owned by the county’s police department to operate in a five mile circle around the county fire station in Toano.
James City police launched a drone team in 2021, but the drone used for this program, called Air 10, is committed solely to responding to heart attacks; a pilot will monitor only the calls in Air 10’s five-mile range in Toano, the county's most rural area, and dispatch the largely automated drone to help when needed.
Once there, the drone will lower an AED approximately 100 feet down on a tether as on-the-ground help is on the way. Dispatchers and the AED’s audible instructions coach bystanders through rendering aid in the meantime.
Though it hasn’t yet responded to an emergency, some early simulations in the county got a drone overhead in two minutes — beating on-the-ground vehicles by six minutes.
“The potential for it to save lives is huge,” said Betsy Sink, battalion chief of EMS operations for the James City County Fire Department. “I think the amount of cardiac arrest patients that we could save if this grew to a national program could be tens of thousands.”
James City County is the latest locality in Hampton Roads to create or expand programs using drones as first responders after Federal Aviation Administration regulations opened new avenues for flying the vehicles in 2025. Newport News and Virginia Beach launched theirs earlier this summer.
Though a private company, Archer First Response Systems, launched a drone AED delivery program in Tampa Bay in 2024, Ornato said the James City and Forsyth project is the first to test embedding the concept inside public emergency services. He said demonstrating that it can work and be replicated, even in a less densely populated community, could make a difference for agencies nationwide.
The project is funded through the end of June 2027 by the American Heart Association. Ornato isn’t sure about exactly how, and if, such programs will be adopted around the U.S. after he and Dr. Monique Starks, his counterpart at Duke, have the study’s findings. But Ornato envisions a possible future where regional hubs employing several fast-acting medical drones stocked with AEDs, stop-the-bleed kits, EpiPens and naloxone could dramatically improve survival rates for health emergencies.
“Now, politically, is that going to be possible? Remains to be seen,” Ornato said. “The future is uncertain, but wide open for potential exploration and cost-effective regionalization of the concept.”
