Emergency aeromedical transport of patients with acute myocardial infarction

Traditional medical treatment of acute myocardial infarction (AMI) calls for immediate admission and observation in a special care unit and prohibits early interhospital transfer of patients. If persons with AMI are to benefit from emergency thrombolytic therapy, angioplasty, and other interventions, they may require emergency transfer within hours to one of the 10% of hospitals that provide these services. We report our experience with the emergency aeromedical treatment and transfer for acute intervention of 104 consecutive patients with suspected AMI. Between May 1983 and December 1984, 104 patients with suspected acute myocardial infarction were transported by an aeromedical team, including a physician and nurse, for emergency cardiac evaluation. AMI was confirmed in 94 (90%), and emergency intervention was carried out in 75 of 104 (72%). Ninety patients (87%) survived to be discharged from the hospital. There were no deaths during transport. Complications requiring treatment occurred in 13 (12%) of the patients during transport; physician skill or judgment was exercised in 27 of 104 transports (26%) and did not correlate with the Killip classification of physical findings. We conclude that emergency transfer of patients with AMI, traditionally considered hazardous, can be carried out safely using an aeromedical team. Physicians appear to play an important role in safe transport.