TITLE:
Establishing Benchmarks for Helicopter EMS Patient Stabilization Times in Interfacility Transport for Primary Percutaneous Coronary Intervention
AUTHORS:
Loren Brown, Annette Arthur, Claudia Keeling, Christine Yuhas, Stephen H. Thomas
KEYWORDS:
Helicopter EMS; Percutaneous Coronary Intervention; Regional Cardiac Care; Benchmarking
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.3 No.7A,
January
2,
2013
ABSTRACT:
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.