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Even with helicopter EMS, hospital transfer can delay treatment for heart attacks
Date:12/7/2010

CINCINNATIHelicopter emergency medical services can be a life saver for patients needing immediate care. But, according to a University of Cincinnati study, the process of activating them often delays treatment beyond recommended times.

The study, published online ahead of print in Annals of Emergency Medicine, was led by assistant professor Jason McMullan, MD. In a multicenter, retrospective chart review, McMullan found that a majority of STEMI heart attack patients transferred by a hospital-based helicopter emergency medical service (HEMS) in 2007 did not receive treatment within the time period recommended by national physician groups.

For patients with a ST-elevation myocardial infarction (STEMI), a type of heart caused by a sudden, total blockage of a coronary artery, the American Heart Association and American College of Cardiologists have set a goal of 30 minutes to open the artery if a clot-busting drug is given (a treatment known as fibrinolysis) or 90 minutes if a stent is to be placed in the artery (percutaneous coronary intervention, or PCI). The length of time from the patient's arrival at the emergency department to treatment by PCI is commonly referred to as "door to balloon" time.

"The goal of treating patients suffering heart attacks is to open a clogged cardiac artery as soon as possible," says McMullan. "While all emergency departments have access to fibrinolysis, not every hospital is capable of PCI. As a result, many people are transferred to a PCI hospital to receive a stent and a helicopter is frequently used to make that transfer as fast as possible."

With the chart review, researchers aimed to estimate the proportion of STEMI patients transported by a hospital-based helicopter who met those national goals.

McMullan reviewed the charts of 179 subjects, flown by a helicopter emergency medical service from 16 referring to six receiving hospitals in Greater Cincinnati. He found that, of th
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Contact: Katy Cosse
kathryn.cosse@uc.edu
513-558-0207
University of Cincinnati Academic Health Center
Source:Eurekalert

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