benefits to morbidity and mortality of these interventions are time-dependent. 4-6 The American College of Cardiology/ American Heart Association guidelines for AMI recommend primary PCI within 90 min of first medical contact, A cute myocardial infarction (AMI) is an important public health problem in the industrialized world. 1,2 Approximately 33,000 patients die of AMI in Japan every year. 3 Since the 2000s, definitive interventions, such as primary percutaneous coronary intervention (PCI), including balloon angioplasty and stent implantation, have improved clinical outcomes for patients with AMI, but the

Objective: The present study involved flight nurses who provide emergency medical care while transporting patients to hospitals, and aimed to examine the structure of their practice. Method: Semi-structured interviews with six flight nurses in the Tokai and Kinki regions were conducted, and the results were analyzed using the KJ method. Results: The flight nurses' practice was classified into the following 7 categories: [Cooperation suggested by themselves to work in collaboration with surrounding health care staff], [Accurate clinical inferences extracted through discussions with physicians], [Flexible responses and ideas], [Efforts to achieve the maximum effect in special and severe health care environments], [Reflection to convert the experiences of individuals into knowledge and share it within the team], [Paying attention to the uniqueness of nursing care provided by flight nurses], and [On-the-job-based training for new flight nurses utilizing knowledge acquired through experience]. Conclusion: The nursing practice of flight nurses has a tri-layer structure: It is based on "the accumulation of core experience" and develops into "future visions" through the process of "brushing up skills learned from experience".