Characteristics of aeromedical transport, both interhospital and directly from the scene of the incident, in patients with acute myocardial infarction or acute trauma between 2011–2016 in Poland: A case-control study

Abstract

Background. Patients with acute myocardial infarction (AMI) or acute trauma (AT) are transported by air to save time. Helicopter Emergency Medical Service (HEMS) provides both flights to and from the emergency scene, as well as interhospital transport (interHtransport).Objectives. The objective of this study was to compare aeromedical transport and HEMS missions of AMI and AT patients regarding safety, medical procedures and the length of flights.Material and methods. This is a case-control study analyzing the medical history records of AMI and AT patients transported between hospitals and from the scene identified using ICD-10 codes. Research of customary data (age, sex and general health status measured with Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS)) was performed.Results. There were 48,555 flights in the years 2011-2016, of which 7,645 (15.7%) were interhospital (19% AMI and 12% AT). Out of these, 40,910 (84.3%) HEMS missions were to patients on the scene (10% AMI and 13% AT). No fatalities were noted. The AMI GCS score was higher than in AT patients: 15.0 vs 14.0, respectively. The medical procedures during transport of AMI patients between hospitals and from the scene were the following: cardiopulmonary resuscitation (CPR): 6 vs 73 cases (p < 0.001); oxygen therapy: 41. 1% vs 50.2%, respectively. The median distance was 59.4 km vs 52. 1 km (p < 0.001), while median flight time was 45.0 min vs 38.0 min (p < 0.001), respectively. Regarding AT patients, the procedures performed (during interhospital and from the scene transport) were the following: CPR: 5 vs 244 cases (p < 0.001); intubation: 10.7% vs 17.3% (p < 0.001); sedation: 50. 1% vs 24.3% (p < 0.001); oxygen therapy: 17.6% vs 36.6% (p < 0.001); spinal board: 17. 1% vs 66% (p < 0.001); cervical collar: 15.9% vs 63.4% (p < 0.001), respectively. Interhospital transport and HEMS mission median flight distance was 135.9 km vs 56.3 km (p < 0.001), while median flight time was 66.0 min vs 45.0 min (p < 0.001), respectively.Conclusions. Aeromedical transport is safe and very rarely requires resuscitation during the flight. The long distances of flights and time required can reflect the scarcity of trauma centers (TCs) compared to cardiovascular wards. The location of hemodynamic centers in Poland is optimal.

Analysis of out-of-hospital cardiac arrest in Poland in a 1-year period: data from the POL-OHCA registry

“…Based on the CSS data, we could assess only survival until hospital admission and transport by HEMS. In a study by Wejnarski et al, 25 no deaths were recorded during aeromedical transportation between 2011 and 2016. Therefore, it could be assumed that all or almost all patients transported by HEMS would survive until hospital admission.…”

Neonatal Transport in the Practice of the Crews of the Polish Medical Air Rescue: A Retrospective Analysis

“…Wejnarski et al (2019) characterized airborne transport, both between hospitals and directly from the site of the event of patients with acute myocardial infarction or acute trauma in Poland between 2011 and 2016. They found that for patients with acute coronary syndrome, the median time that passed from the receipt of the call to patient transfer to the target hospital was 81 min, and the transport distance was 59.4 km, whereas in patients with sudden injury the median time from the receipt of the call to patient transfer to the target hospital was 115 min, and the distance was 135.9 km [42]. The results of the authors' own study showed that the average time from the receipt of the call to patient transfer in the incubator to the target center was much longer and amounted to 269.16 min, while the distance during transport was also greater, that is 304.27 km, compared to the above analyses of air transports [41,42].…”

Effectiveness of LODS, OASIS, and SAPS II to predict in-hospital mortality for intensive care patients with ST elevation myocardial infarction

“…The common variables of LODS and SAPS II are mostly related to outcomes of STEMI. For example, the GCS score was confirmed to be higher in acute myocardial infarction patients than in acute trauma patients 22 . Furthermore, heart rate and blood pressure are undoubtedly closely related to myocardial infarction (especially in intensive care patients with STEMI), which characterizes the severity of the disease.…”