Bleeding complications following initiation of thrombolytic therapy for acute myocardial infarction: A comparison of helicopter-transported and nontransported patients

Fromm, Robert E.; Hoskins, Edwina; Cronin, Laura; Pratt, Craig M.; Spencer, William H.; Roberts, Robert

doi:10.1016/s0196-0644(05)81433-7

Cited by 19 publications

(8 citation statements)

References 17 publications

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“…14 The third study prospectively evaluated the effect of t-PA on bleeding complications that arose in 95 patients during and after interhospital helicopter transport; no episodes of cardiac arrest or cardioversion during transport were reported. 15 The present study involved more patients than the other three combined and has similar results, demonstrating the low incidence of complications and the high safety of interhospital transport of patients with AMI. However, the present study has limitations due to its retrospective design.…”

Section: Discussionsupporting

confidence: 73%

“…A Medline search using multiple search terms (acute myocardial infarct; acute myocardial infarction; interhospital transfer; interhospital transport; transfer; transport) revealed only three English-language studies since 1990 concerned with complications arising during interhospital transfer of patients in the acute stages of AMI. [13][14][15] All of these studies were of patients given thrombolytic therapy.…”

Section: Discussionmentioning

confidence: 99%

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Safety of interhospital transport of patients with acute myocardial infarction

Hooi

1999

Emergency Medicine

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Objectives: To describe the rate of complications in patients who undergo interhospital transport in the early stages of acute myocardial infarction and to determine whether instability in the emergency department is a predictor of these complications. Methods: A retrospective medical record review of patients with proven acute myocardial infarction transferred from Wyong Emergency Department to Gosford Hospital in the period 1994–96 was performed. Results: Three hundred and twenty‐three patients were transported. Four patients required an unplanned intervention; all four patients suffered hypotension and all had an intravenous nitroglycerin infusion. Three patients required fluid resuscitation and one patient developed supraventricular tachycardia with hypotension, treated by cardioversion. No other complications, cardiac arrest or deaths were recorded. Prior patient instability did not predict three out of four complications during transfer and did not predict any complications in non‐intubated patients. Conclusion: Medical escort of stabilized non‐intubated patients in the early stages of acute myocardial infarction is probably unnecessary. Further prospective studies are needed to determine which patients with acute myocardial infarction can be safely transported without a medical escort.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Safety of interhospital transport of patients with acute myocardial infarction

Hooi

1999

Emergency Medicine

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“…Th e benefi ts of air transport have been demonstrated in studies to outweigh stressors that fl ying might add, even for the sickest trauma and, notably, patients suff ering from a myocardial infarction. (1,2,3,4,5,6,7,8,9,10,11,12,13) The use of air medical services (AMS) has become an essential component of the healthcare system. Appropriately Air medical services are a means to bridge geography and time.…”

Section: Benefi Ts Of Air Medical Servicesmentioning

confidence: 99%

What risk managers should know about air medical patient transport: From the association of air medical services

2007

J of Healthc Risk Manag

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The use of air medical services (AMS) has become an essential component of the healthcare system. Appropriately used air medical critical care transport can save lives and reduce the cost of healthcare. It does so by minimizing the time the critically ill and injured spend out of a hospital, by bringing more medical capabilities to the patient than are normally provided by ground emergency medical services, and by helping get the patient to the appropriate specialty care quickly. Risk managers should be aware of the everyday decisions made in critical care transport to ensure the most appropriate utilization of resources to benefit the patient.

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“…This comprehensive review clearly points out the advantages of helicopter transport for patients with acute myocardial infarctions and the safety of administration of IV thrombolytics in the air based on studies published over the past 2 decades. [5][6][7][8] The authors are cautious about their recommendations for use of these service for long-distance emergency AMT. Their legitimate concerns about hypoxemia and gas trapping with altitude have remained an issue since the advent of AMT.…”

Section: Hearts In the Airmentioning

confidence: 99%