"Our results suggest that, when inter-hospital transfers are required, significant delays are introduced, even when a helicopter is used," says McMullan. "A tremendous amount of time is lost in trying to contact a cardiologist to accept the patient, which, during the time period studied, had to be done before Air Care could be called. We recommend that in these situations, hospitals without a PCI capability consider early fibrinolytic therapy."
The study found only one in five patients was treated with fibrinolytic therapy prior to transfer to a hospital with PCI capability. Of those, fewer than half were treated within the 30-minute goal.
Authors point towards delays in the process of activating HEMS that can contribute to delays in treatment.
"The take-home point of our findings is certainly not that helicopter EMS doesn't help STEMI heart attack patients; on the contrary, HEMS undoubtedly saves many lives in getting suburban and rural STEMI patients to cardiac catheterization labs for PCI as rapidly as possible," says paper co-author William Hinckley, MD. "Rather, the point is that calling the helicopter is not like saying, 'Beam me up, Scotty' on 'Star Trek.' It's fast, but it's not instantaneous."
They recommend that hospitals consider strategies to reduce the time required for transfers, possibly by creating a streamlined system in which an emergency medicine physician is able to call for both helicopter transport and cardiologist approval with a single phone call or by allowing non-physician personnel to request a transfer.
Hinckley says other strategies could include enabling rural EMS squads to activate Air Care from the field. Based on the research, he says Air Care is working with physician partners at referring and receiving hospitals to implement such new pro
|Contact: Katy Cosse|
University of Cincinnati Academic Health Center