PMID- 21226552
OWN - NLM
STAT- MEDLINE
DCOM- 20110714
LR  - 20110303
IS  - 1545-0066 (Electronic)
IS  - 1090-3127 (Linking)
VI  - 15
IP  - 2
DP  - 2011 Apr-Jun
TI  - Safe transport of patients with acute coronary syndrome or cardiogenic shock by 
      skilled air medical crews.
PG  - 240-5
LID - 10.3109/10903127.2010.541978 [doi]
AB  - INTRODUCTION: Acute coronary syndrome (ACS) is a spectrum of disease that 
      includes unstable angina (UA), non?ST-segment elevation myocardial infarction 
      (NSTEMI), and ST-segment elevation myocardial infarction (STEMI). Cardiogenic 
      shock is a severe complication of an ACS. Evidence suggests that emergent primary 
      coronary intervention is the treatment of choice for patients with acute STEMI, 
      and patients who have hemodynamic instability or suffer a major complication of 
      therapy also require emergent intervention. These patients may require emergent 
      interfacility transfer for this intervention. OBJECTIVE: This study examined ACS 
      patient transfers to determine the incidence of adverse events (AEs) during 
      transfer in a large transport medicine service. METHODS: This was a retrospective 
      review of prospectively collected data for air medical transfer of ACS or 
      cardiogenic shock patients in Ontario, Canada, from January 2005 to June 2007. 
      Call records and patient care reports were screened for AE identifiers, including 
      resuscitation medication and procedure and unstable cardiac rhythms. Each chart 
      with an AE was independently reviewed by two investigators, with consensus in 
      cases of disagreement, to determine the incidence and type of AE. RESULTS: During 
      the study period, there were 2,258 transfers for which the patient had a primary 
      diagnosis of ACS or cardiogenic shock. The mean age was 62 years (range 24-91 
      years), and 68% of the patients were male. Investigators identified one or more 
      AEs that occurred during 127 (5.6%) patient transfers, with hypotension (n = 80), 
      increasing chest pain (n = 52), and arrhythmia (n = 18) as the three most common 
      AEs. There was one death in flight. Management of the AEs was within the scope of 
      practice of transport personnel in all but one case. CONCLUSION: The incidence of 
      AEs in air medical transport of ACS patients is low. Air medical crews can safely 
      transport this potentially unstable patient population.
FAU - Trojanowski, Jan
AU  - Trojanowski J
AD  - Division of Emergency Medicine, Faculty of Medicine, University of Western 
      Ontario, London, Canada.
FAU - MacDonald, Russell D
AU  - MacDonald RD
LA  - eng
PT  - Journal Article
DEP - 20110112
PL  - England
TA  - Prehosp Emerg Care
JT  - Prehospital emergency care
JID - 9703530
SB  - IM
MH  - *Acute Coronary Syndrome
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Air Ambulances
MH  - Chest Pain
MH  - Emergency Medical Technicians
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Hypotension
MH  - Male
MH  - Middle Aged
MH  - Patient Care/*methods
MH  - Patient Transfer/*methods
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Safety
MH  - *Shock, Cardiogenic
MH  - Young Adult
EDAT- 2011/01/14 06:00
MHDA- 2011/07/16 06:00
CRDT- 2011/01/14 06:00
PHST- 2011/01/14 06:00 [entrez]
PHST- 2011/01/14 06:00 [pubmed]
PHST- 2011/07/16 06:00 [medline]
AID - 10.3109/10903127.2010.541978 [doi]
PST - ppublish
SO  - Prehosp Emerg Care. 2011 Apr-Jun;15(2):240-5. doi: 10.3109/10903127.2010.541978. 
      Epub 2011 Jan 12.