Strategic Vertical Port Placement and Routing of Unmanned Aerial Vehicles for Automated Defibrillator Delivery in Mountainous Areas

Out-of-hospital cardiac arrest (OHCA) is a major cause of death during mountain activities in the Alpine regions. Due to the time-critical nature of these emergencies and the logistical challenges of remote terrain, emergency medical services (EMS) are investigating the use of unmanned aerial vehicles (UAVs) to deliver automated external defibrillators (AEDs). This study presents a geospatial strategy for optimising AED delivery by UAVs in mountainous environments, using the Province of South Tyrol, Italy, as a model region. A Geographic Information System (GIS) framework was developed to identify suitable sites for vertical drone ports based on terrain, infrastructure, and regulatory constraints. A Low-Altitude-Flight Elevation Model (LAFEM) was implemented to generate obstacle-avoiding, regulation-compliant 3D flight paths using least-cost path analysis. The results identified 542 potential vertical-port locations, covering approximately 49% of South Tyrol within ten minutes of flight, and demonstrated significant time savings for AED delivery in field tests compared with manual and Euclidean routing. These findings show that integrating GIS-based vertical-port placement and terrain-adaptive UAV routing can substantially improve AED accessibility and response times in mountainous regions. The LAFEM model aligns with U-space airspace regulations and supports safe, automated AED deployment for improved outcomes in OHCA emergencies.