Defibrillation and external pacing in flight: incidence and implications

Daly, Stuart; Milne, Helen J; Holmes, Dan P; Corfield, Alasdair

doi:10.1136/emermed-2012-202028

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Although transport and retrieval of patients on TCP is a well known patient category for a pre‐hospital and retrieval service, to our knowledge this is the first report describing the insertion of TVP wires by the retrieval team. Gangathimmaiah recently described the technique of insertion but no patient outcome secondary to insertion was analysed.…”

Section: Discussionmentioning

confidence: 99%

Cardiac transvenous pacing in the retrieval setting: A retrospective case series

Remilton

Hesselfeldt²,

Mazur

2019

Emerg Medicine Australasia

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Objectives: To report on the safety and efficacy of transvenous cardiac pacing wire insertion outside a tertiary hospital by a medical retrieval service. Methods: SAAS MedSTAR Emergency Medical Retrieval Service transports symptomatic bradycardic patients in rural South Australia to Adelaide on transvenous pacing for ongoing management. This is a retrospective case review of all transvenous cardiac pacing wires inserted by SAAS MedSTAR between January 2015 and October 2017. Results: This study demonstrated successful insertion of cardiac transvenous pacing wires and cardiac capture in 10 of 11 cases (91%) by pre-hospital and retrieval doctors. There were no immediate or longterm complications from insertion. All of the patients were successfully transferred by helicopter or fixed wing to their receiving facility, with nine of the 11 patients (82%) surviving to hospital discharge. Conclusion: This paper demonstrates that transvenous cardiac pacing can be safely and successfully implemented for symptomatic patients by pre-hospital and retrieval physicians in the aeromedical retrieval setting.

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Section: Discussionmentioning

confidence: 99%

Cardiac transvenous pacing in the retrieval setting: A retrospective case series

Remilton

Hesselfeldt²,

Mazur

2019

Emerg Medicine Australasia

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“…Given the fact that the 3 PCI centres share the on duty rotation during the night, transport distances will increase and may reach up to 90 km. Thus employment of helicopters during night hours could contribute to reduced ischemia times [ 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study

Trimmel

Bayer

Schreiber

et al. 2018

Scand J Trauma Resusc Emerg Med

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BackgroundMyocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria.MethodsThe Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km2. Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres. Treatment guidelines were updated in 2012 and documentation within a web-based STEMI registry became mandatory. For this retrospective qualitative control study, data from February 2012–April 2015 was assessed.ResultsA total of 416 STEMI cases were documented, and 99% were identified by EMS within 6 (4.0–8.0) minutes after arrival. Median time loss between onset of pain and EMS call was 54 (20–135) minutes; response, pre-hospital and door-to-balloon times were 14 (10–20), 46 (37–59) and 45 (32–66) minutes, respectively. When general practitioners were involved, time between onset of pain and balloon inflation significantly increased from 180 (135–254) to 218 (155–348) minutes (p < .001). A pre-hospital time < 30 min was achieved in 25.8% of all patients during the day vs. 11.6% during the night (p < .001). Three hundred forty-five patients (83%) were subjected to primary percutaneous coronary intervention (PPCI), and 6.5% were thrombolysed by EMS. Pre-hospital complication rate was 18% (witnessed cardiac arrest 7%, threatening arrhythmias 6%, cardiogenic shock 5%). Twenty-four hours and hospital mortality rate were 1.2 and 2.8%, respectively.DiscussionOptimal patient care and subsequently outcome of STEMI is strongly determined by a short patient-decision time to call EMS and by the first medical contact to balloon time (FMCBT). Supra-regional networks are key in order to increase the efficacy and efficiency of health care. The goal of 120 min FMCBT was achieved in 78% of our patients immediately managed by EMS, thus indicating room for improvement.ConclusionIn conclusion, results from the Eastern Austrian STEMI network shed light on the necessity of increasing patient awareness in order to minimize any time loss derived by delayed EMS calls. Involvement of family physicians resulted in prolonged FMCBT. A stronger utilization of rescue helicopters could further improve the efficacy of this supra-regional network. Nevertheless PPCI rates, time intervals and outcome rates compare well with international benchmarks.

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Challenges and Resources for New Critical Care Transport Crewmembers: A Descriptive Exploratory Study

Alfes

Steiner

Rutherford-Hemming

2016

Air Medical Journal

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Defibrillation and external pacing in flight: incidence and implications

Cited by 5 publications

References 21 publications

Cardiac transvenous pacing in the retrieval setting: A retrospective case series

Cardiac transvenous pacing in the retrieval setting: A retrospective case series

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study

Challenges and Resources for New Critical Care Transport Crewmembers: A Descriptive Exploratory Study

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