Physical Distance Between the Helipad and Cardiac Catheterization Laboratory: A Cause for Delay in Helicopter Air...

Decreased time to cardiac catheterization improves survival and limits cardiac tissue damage in ST Elevation myocardial infarction (STEMI). Emergency medical services delays account for half of treatment delays in STEMI. Helicopter air ambulance (HAA) can reduce the time to percutaneous intervention (PCI), and therefore may reduce mortality. The impact of physical distance between the PCI hospital helipad and the PCI laboratory on the door-to-door-to-balloon time (DDBT) for cardiac intervention in STEMI patients transported through HAA from remote community hospitals to PCI facilities was assessed.

This was a retrospective chart review of interfacility STEMI patients where HAA was activated to reduce DDBT from January 1, 2020, to January 1, 2023. The HAA agency under review transports STEMI patients to 2 PCI centers. There is a significant difference in the distance between the helipad and the PCI laboratory at the 2 hospitals. Descriptive statistics were used to compare DDBT as well as the time from HAA arrival at the PCI hospital helipad to the cardiac catheterization laboratory.

Data were available for 91 STEMI cases. The median time for DDBT was 89.9 minutes with a median time of 10.5 minutes from helipad arrival to catheterization laboratory (Table 1). Of the 91 cases, 69 (76%) were from hospital A and 22 (24%) were from hospital B. There was no detectable difference in the distribution of DDBT times between hospitals (P = .47). Helipad arrival times to cardiac catheterization laboratory were significantly longer for hospital A than hospital B (P < .001). The median time for hospital A was 11.0 minutes (interquartile range, 9.2-14.0) compared with hospital B, which had a median of 5.4 minutes (5.0-7.3).

The physical distance a PCI laboratory is located from the helipad can be a significant addition to ischemic time for STEMI patients.