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Aeromedical transfer to reduce delay in primary angioplasty.
MedLine Citation:
PMID:  21458139     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Aeromedical transfer can reduce transfer times for primary percutaneous coronary intervention (PPCI). Delays in dispatch of the helicopter and landing-reperfusion can reduce the benefits of air travel. The ad hoc nature of these transfers may compound delays. A formal aeromedical transfer service, with rapid dispatch protocols and rapid landing to balloon times could significantly reduce reperfusion times. METHODS: A standard operating procedure (SOP) was developed using a field assessment team (doctor, aircrew paramedic) and a cardiologist-led multidisciplinary team meeting the incoming aircraft. The aeromedical SOP for STEMI care was implemented when anticipated land journey >30min to the nearest PPCI centre. Reperfusion times for actual air travel and estimated virtual land journeys from the same location were compared. RESULTS: Between April and December 2009, 8 patients were managed according to the aeromedical SOP. Median air distance 49 miles and road, 40 miles. All subsequent data shown in median minutes (range). Call-balloon time 109 (97-116). Call-aeromedical activation 13 (9-26). Aeromedical activation-arrive scene 12 (9-16). Time at scene 29 (24-52). Call-depart scene 57 (45-75). Air journey 25 (18-30) and landing-balloon 21 (8-22). Call-arrive at PPCI centre for air 85 (70-95); estimated virtual road call-arrive at PPCI centre 102 (85-104). CONCLUSIONS: This SOP delivered sub 120min call-balloon times in all cases undergoing PPCI from difficult locations where anticipated land journeys were >30min. With longer anticipated land journeys (or more remote locations) the proportional gains with air transfer will be greater. Subject to a formal SOP and very rapid landing-balloon times, aeromedical transfer can significantly reduce the number of patients suffering long reperfusion delays in acute myocardial infarction.
Authors:
Matthew Balerdi; Daniel Y Ellis; Philip Grieve; Paul Murray; Miles Dalby
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-30
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Harefield Hospital, Hill End Road, Harefield, London, UB96JH, United Kingdom.
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