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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Helicopter transport effectiveness of patients for primary percutaneous coronary intervention

Miranda Phillips1, Annette O Arthur, Raj Chandwaney

  • 1Department of Emergency Medicine, University of Oklahoma School of Community Medicine, Tulsa, OK 74104, USA.

Air Medical Journal
|May 2, 2013
PubMed

Insights

Helicopter emergency medical services (HEMS) for ST-elevated myocardial infarction (STEMI) patients did not show a direct time savings compared to ground emergency medical services (EMS). However, HEMS transports may save approximately 1.2 lives per 100 flights by reducing mortality.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Time to primary percutaneous coronary intervention (PCI) is critical for myocardial salvage in ST-elevated myocardial infarction (STEMI).
  • Helicopter emergency medical service (HEMS) plays a role in regionalized cardiac care.
  • Interfacility transport logistics for STEMI patients undergoing primary PCI require evaluation.

Purpose of the Study:

  • To assess the logistics of HEMS and ground emergency medical services (EMS) for interfacility transport of STEMI patients.
  • To determine the effectiveness of HEMS in terms of lives saved per 100 flights.

Main Methods:

  • Retrospective review of interfacility transports of STEMI patients for primary PCI.
  • Study period: 18 months (January 2010 - June 2011).
  • Comparison of pretransport handling times, door-to-PCI times, and transport distances between HEMS and ground EMS.

Main Results:

  • 66% of reviewed STEMI patients were transported by HEMS.
  • Pretransport handling times were similar for HEMS and ground EMS.
  • Ground EMS achieved faster door-to-PCI times (<90 minutes) more frequently than HEMS.
  • HEMS patients traveled significantly farther distances.
  • Estimated median time savings for HEMS transports: 41 minutes.
  • 78.8% of HEMS flights saved over 30 minutes.

Conclusions:

  • Direct time savings were not demonstrated for HEMS versus ground EMS.
  • Analysis of estimated ground EMS times for HEMS patients suggests a median time savings of 41 minutes.
  • HEMS demonstrated a time-based mortality effectiveness of approximately 1.2 lives saved per 100 flights.
Abstract

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