Helicopter EMS (HEMS) allows for patients to be quickly transported into regional cardiac centers, often to receive primary percutaneous coronary intervention (PCI). Since PCI is a time-critical therapy, it is importa...Helicopter EMS (HEMS) allows for patients to be quickly transported into regional cardiac centers, often to receive primary percutaneous coronary intervention (PCI). Since PCI is a time-critical therapy, it is important that patients get to primary PCI as quickly as possible. HEMS crews’ “on-scene” times for trauma patients have been extensively studied, and recent years have seen many efforts to minimize the time required to prepare patients for transport. There has been less attention to interfacility transport “scene times” for HEMS crews at referring hospitals;this includes stabilization times for preparing cardiac patients for loading onto aircraft for HEMS transport to primary PCI. In the absence of guiding evidence, system benchmarking and quality improvement are difficult. Therefore the current study was undertaken, to assess and describe the HEMS crew “on-scene” times or “patient stabilization times” (PSTs) at referring hospitals, for interfacility transported cardiac patients flown for primary PCI. Descriptive analysis identified a PST median of 19 minutes (interquartile range 15 - 24), and univariate analyses using Kruskal-Wallis testing found no association between prolonged PST and sending unit type (Emergency Department versus other), off-hours transports, or relatively frequent (at least monthly) use of HEMS (p for all comparisons > 0.64). Outlier PSTs, defined a priori as those exceeding the median by at least a half-hour, were found in 12% of all cases. These data could be useful as a starting point for system planning and benchmarking efforts in regionalized systems of acute cardiac care.展开更多
Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of H...Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of time-criticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.展开更多
文摘Helicopter EMS (HEMS) allows for patients to be quickly transported into regional cardiac centers, often to receive primary percutaneous coronary intervention (PCI). Since PCI is a time-critical therapy, it is important that patients get to primary PCI as quickly as possible. HEMS crews’ “on-scene” times for trauma patients have been extensively studied, and recent years have seen many efforts to minimize the time required to prepare patients for transport. There has been less attention to interfacility transport “scene times” for HEMS crews at referring hospitals;this includes stabilization times for preparing cardiac patients for loading onto aircraft for HEMS transport to primary PCI. In the absence of guiding evidence, system benchmarking and quality improvement are difficult. Therefore the current study was undertaken, to assess and describe the HEMS crew “on-scene” times or “patient stabilization times” (PSTs) at referring hospitals, for interfacility transported cardiac patients flown for primary PCI. Descriptive analysis identified a PST median of 19 minutes (interquartile range 15 - 24), and univariate analyses using Kruskal-Wallis testing found no association between prolonged PST and sending unit type (Emergency Department versus other), off-hours transports, or relatively frequent (at least monthly) use of HEMS (p for all comparisons > 0.64). Outlier PSTs, defined a priori as those exceeding the median by at least a half-hour, were found in 12% of all cases. These data could be useful as a starting point for system planning and benchmarking efforts in regionalized systems of acute cardiac care.
文摘Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of time-criticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.
