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Type: Journal article
Title: Aeromedical transfer to reduce delay in primary angioplasty
Author: Balerdi, M.
Ellis, D.
Grieve, P.
Murray, P.
Dalby, M.
Citation: Resuscitation, 2011; 82(7):947-950
Publisher: Elsevier Sci Ireland Ltd
Issue Date: 2011
ISSN: 0300-9572
Statement of
Matthew Balerdi, Daniel Y. Ellis, Philip Grieve, Paul Murray, Miles Dalby
Abstract: <h4>Background</h4>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.<h4>Methods</h4>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 >30 min to the nearest PPCI centre. Reperfusion times for actual air travel and estimated virtual land journeys from the same location were compared.<h4>Results</h4>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).<h4>Conclusions</h4>This SOP delivered sub 120 min call-balloon times in all cases undergoing PPCI from difficult locations where anticipated land journeys were >30 min. 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.
Keywords: Acute myocardial infarction; Helicopter retrieval; Emergency ambulance system; Dispatch; Cardiac care
Rights: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
RMID: 0020118090
DOI: 10.1016/j.resuscitation.2011.02.031
Appears in Collections:Anaesthesia and Intensive Care publications

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