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https://hdl.handle.net/2440/71411
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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 1873-1570 |
Statement of Responsibility: | 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. |
DOI: | 10.1016/j.resuscitation.2011.02.031 |
Published version: | http://dx.doi.org/10.1016/j.resuscitation.2011.02.031 |
Appears in Collections: | Anaesthesia and Intensive Care publications Aurora harvest |
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