Aeromedical transfer to reduce delay in primary angioplasty

Area of Science:

• Emergency medicine
• Cardiology
• Aeromedical services

Background:

• Aeromedical transfer can shorten treatment times for primary percutaneous coronary intervention (PPCI).
• Delays in helicopter dispatch and landing-to-reperfusion times can negate the benefits of air transport.
• A formal aeromedical service with rapid protocols can significantly decrease reperfusion times.

Purpose of the Study:

• To evaluate the effectiveness of a formal aeromedical standard operating procedure (SOP) for ST-elevation myocardial infarction (STEMI) care.
• To compare reperfusion times for aeromedical transfers versus estimated ground transport times.

Main Methods:

• A multidisciplinary team developed and implemented an aeromedical SOP for STEMI patients.
• The SOP was used for transfers where the anticipated land journey exceeded 30 minutes.
• Reperfusion times were compared between actual air travel and simulated road journeys.

Main Results:

• Eight patients were managed under the aeromedical SOP between April and December 2009.
• The median call-to-balloon time was 109 minutes for aeromedical transfers.
• Aeromedical transfer resulted in faster arrival at the PPCI center (median 85 minutes) compared to estimated ground transport (median 102 minutes).

Conclusions:

• The implemented SOP achieved call-to-balloon times under 120 minutes for all patients.
• Aeromedical transfer offers greater time savings for longer anticipated ground journeys or more remote locations.
• A formal SOP and rapid landing-to-balloon times are crucial for reducing reperfusion delays in acute myocardial infarction.