University of Hertfordshire

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Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study

Research output: Contribution to journalArticlepeer-review

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Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study. / Pathan, Sameer; Soulek, Jason; Qureshi, Isma; Werman, Howard; Reimer, Andrew; Brunko, Michael W.; Alinier, Guillaume; Irfan, Furqan B.; Thomas, Stephen Hodges.

In: Journal of Emergency Medicine, Trauma, and Acute Care, 19.09.2017, p. 1-16.

Research output: Contribution to journalArticlepeer-review

Harvard

Pathan, S, Soulek, J, Qureshi, I, Werman, H, Reimer, A, Brunko, MW, Alinier, G, Irfan, FB & Thomas, SH 2017, 'Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study', Journal of Emergency Medicine, Trauma, and Acute Care, pp. 1-16. https://doi.org/10.5339/jemtac.2017.8

APA

Pathan, S., Soulek, J., Qureshi, I., Werman, H., Reimer, A., Brunko, M. W., Alinier, G., Irfan, F. B., & Thomas, S. H. (2017). Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study. Journal of Emergency Medicine, Trauma, and Acute Care, 1-16. [8]. https://doi.org/10.5339/jemtac.2017.8

Vancouver

Author

Pathan, Sameer ; Soulek, Jason ; Qureshi, Isma ; Werman, Howard ; Reimer, Andrew ; Brunko, Michael W. ; Alinier, Guillaume ; Irfan, Furqan B. ; Thomas, Stephen Hodges. / Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study. In: Journal of Emergency Medicine, Trauma, and Acute Care. 2017 ; pp. 1-16.

Bibtex

@article{3d95cc79c97a4994b753feac87af628e,
title = "Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study",
abstract = "Background: Helicopter emergency medical services (HEMS) and ground EMS (GEMS) are both integral parts of out-of-hospital transport systems for patients with ST-elevation myocardial infarction (STEMI) undergoing emergency transport for primary percutaneous coronary intervention (PPCI). There are firm data linking time savings for PPCI transports with improved outcome. A previous pilot analysis generated preliminary estimates for potential HEMS-associated time savings for PPCI transports.Methods: This non-interventional multicenter study conducted over the period 2012–2014 at six centers in the USA and in the State of Qatar assessed a consecutive series of HEMS transports for PPCI; at one center, consecutive GEMS transports of at least 15 miles were also assessed if they came from sites that also used HEMS (dual-mode referring hospitals). The study assessed time from ground or air EMS dispatch to transport a patient to a cardiac center, through to the time of patient arrival at the receiving cardiac unit, to determine proportions of patients arriving within accepted 90- and 120-minute time windows for PPCI. Actual times were compared to “route-mapping” GEMS times generated using geographical information software. HEMS{\textquoteright} potential time savings were calculatedusing program-specific aircraft characteristics, and the potential time savings for HEMS was translated into estimated mortality benefit.Results: The study included 257 HEMS and 27 GEMS cases. HEMS cases had a high rate of overall transport time (from dispatch to receiving cardiac unit arrival) that fell within the predefined windows of 90 minutes (67.7% of HEMS cases) and 120 minutes (91.1% of HEMS cases). As compared to thecalculated GEMS times, HEMS was estimated to accrue a median time saving of 32 minutes (interquartile range, 17–46). The number needed to transport for HEMS to get one additional case to PPCI within 90 minutes was 3. In the varied contexts of this multicenter study, the number of lives saved by HEMS, solely through time savings, was calculated as 1.34 per 100 HEMS PPCI transports.Conclusions: In this multicenter study, HEMS PPCI transport was found to be appropriate as defined by meeting predefined time windows. The overall estimate for lives saved through time savings alone was consistent with previous pilot data and was also generally consistent with favorable cost-effectiveness.Further research is necessary to confirm these findings, but judicious HEMS deployment for PPCI transports is justified by these data.",
keywords = "air medical transport, helicopter EMS, logistics, STEMI",
author = "Sameer Pathan and Jason Soulek and Isma Qureshi and Howard Werman and Andrew Reimer and Brunko, {Michael W.} and Guillaume Alinier and Irfan, {Furqan B.} and Thomas, {Stephen Hodges}",
note = "This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. {\textcopyright}2017 The Author(s), licensee HBKU Press.",
year = "2017",
month = sep,
day = "19",
doi = "10.5339/jemtac.2017.8",
language = "English",
pages = "1--16",
journal = "Journal of Emergency Medicine, Trauma, and Acute Care",
issn = "1999-7086",
publisher = "Bloomsbury Qatar Foundation Journals",

}

RIS

TY - JOUR

T1 - Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS study

AU - Pathan, Sameer

AU - Soulek, Jason

AU - Qureshi, Isma

AU - Werman, Howard

AU - Reimer, Andrew

AU - Brunko, Michael W.

AU - Alinier, Guillaume

AU - Irfan, Furqan B.

AU - Thomas, Stephen Hodges

N1 - This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. ©2017 The Author(s), licensee HBKU Press.

PY - 2017/9/19

Y1 - 2017/9/19

N2 - Background: Helicopter emergency medical services (HEMS) and ground EMS (GEMS) are both integral parts of out-of-hospital transport systems for patients with ST-elevation myocardial infarction (STEMI) undergoing emergency transport for primary percutaneous coronary intervention (PPCI). There are firm data linking time savings for PPCI transports with improved outcome. A previous pilot analysis generated preliminary estimates for potential HEMS-associated time savings for PPCI transports.Methods: This non-interventional multicenter study conducted over the period 2012–2014 at six centers in the USA and in the State of Qatar assessed a consecutive series of HEMS transports for PPCI; at one center, consecutive GEMS transports of at least 15 miles were also assessed if they came from sites that also used HEMS (dual-mode referring hospitals). The study assessed time from ground or air EMS dispatch to transport a patient to a cardiac center, through to the time of patient arrival at the receiving cardiac unit, to determine proportions of patients arriving within accepted 90- and 120-minute time windows for PPCI. Actual times were compared to “route-mapping” GEMS times generated using geographical information software. HEMS’ potential time savings were calculatedusing program-specific aircraft characteristics, and the potential time savings for HEMS was translated into estimated mortality benefit.Results: The study included 257 HEMS and 27 GEMS cases. HEMS cases had a high rate of overall transport time (from dispatch to receiving cardiac unit arrival) that fell within the predefined windows of 90 minutes (67.7% of HEMS cases) and 120 minutes (91.1% of HEMS cases). As compared to thecalculated GEMS times, HEMS was estimated to accrue a median time saving of 32 minutes (interquartile range, 17–46). The number needed to transport for HEMS to get one additional case to PPCI within 90 minutes was 3. In the varied contexts of this multicenter study, the number of lives saved by HEMS, solely through time savings, was calculated as 1.34 per 100 HEMS PPCI transports.Conclusions: In this multicenter study, HEMS PPCI transport was found to be appropriate as defined by meeting predefined time windows. The overall estimate for lives saved through time savings alone was consistent with previous pilot data and was also generally consistent with favorable cost-effectiveness.Further research is necessary to confirm these findings, but judicious HEMS deployment for PPCI transports is justified by these data.

AB - Background: Helicopter emergency medical services (HEMS) and ground EMS (GEMS) are both integral parts of out-of-hospital transport systems for patients with ST-elevation myocardial infarction (STEMI) undergoing emergency transport for primary percutaneous coronary intervention (PPCI). There are firm data linking time savings for PPCI transports with improved outcome. A previous pilot analysis generated preliminary estimates for potential HEMS-associated time savings for PPCI transports.Methods: This non-interventional multicenter study conducted over the period 2012–2014 at six centers in the USA and in the State of Qatar assessed a consecutive series of HEMS transports for PPCI; at one center, consecutive GEMS transports of at least 15 miles were also assessed if they came from sites that also used HEMS (dual-mode referring hospitals). The study assessed time from ground or air EMS dispatch to transport a patient to a cardiac center, through to the time of patient arrival at the receiving cardiac unit, to determine proportions of patients arriving within accepted 90- and 120-minute time windows for PPCI. Actual times were compared to “route-mapping” GEMS times generated using geographical information software. HEMS’ potential time savings were calculatedusing program-specific aircraft characteristics, and the potential time savings for HEMS was translated into estimated mortality benefit.Results: The study included 257 HEMS and 27 GEMS cases. HEMS cases had a high rate of overall transport time (from dispatch to receiving cardiac unit arrival) that fell within the predefined windows of 90 minutes (67.7% of HEMS cases) and 120 minutes (91.1% of HEMS cases). As compared to thecalculated GEMS times, HEMS was estimated to accrue a median time saving of 32 minutes (interquartile range, 17–46). The number needed to transport for HEMS to get one additional case to PPCI within 90 minutes was 3. In the varied contexts of this multicenter study, the number of lives saved by HEMS, solely through time savings, was calculated as 1.34 per 100 HEMS PPCI transports.Conclusions: In this multicenter study, HEMS PPCI transport was found to be appropriate as defined by meeting predefined time windows. The overall estimate for lives saved through time savings alone was consistent with previous pilot data and was also generally consistent with favorable cost-effectiveness.Further research is necessary to confirm these findings, but judicious HEMS deployment for PPCI transports is justified by these data.

KW - air medical transport

KW - helicopter EMS

KW - logistics

KW - STEMI

U2 - 10.5339/jemtac.2017.8

DO - 10.5339/jemtac.2017.8

M3 - Article

SP - 1

EP - 16

JO - Journal of Emergency Medicine, Trauma, and Acute Care

JF - Journal of Emergency Medicine, Trauma, and Acute Care

SN - 1999-7086

M1 - 8

ER -