This project was supported in part by an Institutional Clinical and Translational Science Award, NIH/NCRR Grant 5UL1RR026314-02.
Original Research Contribution
Ground Emergency Medical Services Requests for Helicopter Transfer of ST-segment Elevation Myocardial Infarction Patients Decrease Medical Contact to Balloon Times in Rural and Suburban Settings
Version of Record online: 9 FEB 2012
© 2012 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 19, Issue 2, pages 153–160, February 2012
How to Cite
McMullan, J. T., Hinckley, W., Bentley, J., Davis, T., Fermann, G. J., Gunderman, M., Hart, K. W., Knight, W. A., Lindsell, C. J., Miller, C., Shackleford, A. and Brian Gibler, W. (2012), Ground Emergency Medical Services Requests for Helicopter Transfer of ST-segment Elevation Myocardial Infarction Patients Decrease Medical Contact to Balloon Times in Rural and Suburban Settings. Academic Emergency Medicine, 19: 153–160. doi: 10.1111/j.1553-2712.2011.01273.x
The authors have no potential conflicts of interest to disclose.
Supervising Editor: Brigitte Baumann, MD.
- Issue online: 9 FEB 2012
- Version of Record online: 9 FEB 2012
- Received July 13, 2011; revisions received September 23 and October 13, 2011; accepted October 20, 2011.
ACADEMIC EMERGENCY MEDICINE 2012; 19:153–160 © 2012 by the Society for Academic Emergency Medicine
Objectives: ST-segment elevation myocardial infarction (STEMI) care is time-dependent. Many STEMI patients require interhospital helicopter transfer for percutaneous coronary intervention (PCI) if ground emergency medical services (EMS) initially transport the patient to a non-PCI center. This investigation models potential time savings of ground EMS requests for helicopter EMS (HEMS) transport of a STEMI patient directly to a PCI center, rather than usual transport to a local hospital with subsequent transfer.
Methods: Data from a multicenter retrospective chart review of STEMI patients transferred for primary PCI by a single HEMS agency over 12 months were used to model medical contact to balloon times (MCTB) for two scenarios: a direct-to-scene HEMS response and hospital rendezvous after ground EMS initiation of transfer.
Results: Actual MCTB median time for 36 hospital-initiated transfers was 160 minutes (range = 116 to 321 minutes). Scene response MCTB median time was estimated as 112 minutes (range = 69 to 187 minutes). The difference in medians was 48 minutes (95% confidence interval [CI] = 33 to 62 minutes). Hospital rendezvous MCTB median time was estimated as 113 minutes (range = 74 to 187 minutes). The difference in medians was 47 minutes (95% CI = 32 to 62 minutes). No patient had an actual MCTB time of less than 90 minutes; in the scene response and hospital rendezvous scenarios, 2 of 36 (6%) and 3 of 36 (8%), respectively, would have had MCTB times under 90 minutes.
Conclusions: In this setting, ground EMS initiation of HEMS transfers for STEMI patients has the potential to reduce MCTB time, but most patients will still not achieve MCTB time of less than 90 minutes.