Air Ambulance Transport Times and Advanced Cardiac Life Support Interventions during the Interfacility Transfer of Patients with Acute ST-segment Elevation Myocardial Infarction

Abstract

The majority of interfacility rotor-wing air ambulance transfers of patients with STEMI achieved a total transfer time of < or = 2 hours. Clinical decompensation requiring ALS treatment occurred in a small percentage of patients. Diabetes, prior arrest or decompensation, and delays to transport were associated with clinical decompensation in the air. Efforts to reduce delays to transport may reduce this risk in transported patients.

Ground Emergency Medical Services Requests for Helicopter Transfer of ST‐segment Elevation Myocardial Infarction Patients Decrease Medical Contact to Balloon Times in Rural and Suburban Settings

“…To maximize effect, each actual flight served as an internal control for each of two scenarios. Transport time intervals in this cohort are similar to those previously reported in a review of almost 3,200 HEMS interfacility transfers of STEMI patients, suggesting that the studied HEMS agency performs similarly to others 17 . However, this is the first report in the literature evaluating potential alternative dispatch scenarios, and the striking difference between actual and modeled times deserves further evaluation.…”

“…Briefly, EMS run sheets and both transferring and receiving hospital charts of all interhospital STEMI transfers by the HEMS service during 2007 were reviewed and underwent dual data abstraction using structured case report forms with prespecified data definitions. Data collected included that necessary to determine treatment and transport intervals, including ground EMS, referring hospital, HEMS course, and PCI segments 17 . Abstractors were trained by a senior investigator; discrepancies in case report forms underwent an adjudication process whereby a senior investigator independently reviews the chart to clarify data queries.…”

Role of Emergency Medical Services in Disaster Response: Resource Document for the National Association of EMS Physicians Position Statement

“…13 Traditional EMS performance measures have focused on response times, [14][15][16][17][18] appropriate patient selection for prehospital rapidsequence intubation (RSI) 19 and air versus ground transportation, 20 and out-of-hospital cardiac arrest survival. 21,22 Newer efforts are expanding EMS benchmarks for various clinical entities encountered by EMS systems, such as ST-segment elevation myocardial infarction (STEMI), [23][24][25] acute stroke, 26 pulmonary edema, asthma, and seizures. 27 Examples of disaster response-based metrics that are currently being studied include appropriateness of triage level, transportation to a hospital with suitable treatment capability, and time-dependent mortality of victims.…”

Outcomes of Physician‐Staffed Versus Non‐Physician‐Staffed Helicopter Transport for ST‐Elevation Myocardial Infarction

“…Helicopter Emergency Medical Services (HEMS) are commonly used to transport patients from non‐PCI centers (ie, STEMI referral hospitals) to PCI centers (ie, STEMI receiving hospitals). HEMS have been shown to be feasible, safe, and reduce transport time to the receiving facility . Thus, HEMS are important in rural or urban areas where ground transport times are predicted to be too long.…”