Establishing Benchmarks for Helicopter EMS Patient Stabilization Times in Interfacility Transport for Primary Percutaneous Coronary Intervention

Abstract

Helicopter EMS (HEMS) allows for patients to be quickly transported into regional cardiac centers, often to receive primary percutaneous coronary intervention (PCI). Since PCI is a time-critical therapy, it is important that patients get to primary PCI as quickly as possible. HEMS crews’ “on-scene” times for trauma patients have been extensively studied, and recent years have seen many efforts to minimize the time required to prepare patients for transport. There has been less attention to interfacility transport “scene times” for HEMS crews at referring hospitals; this includes stabilization times for preparing cardiac patients for loading onto aircraft for HEMS transport to primary PCI. In the absence of guiding evidence, system benchmarking and quality improvement are difficult. Therefore the current study was under taken, to assess and describe the HEMS crew “on-scene” times or “patient stabilization times” (PSTs) at referring hos pitals, for interfacility transported cardiac patients flown for primary PCI. Descriptive analysis identified a PST median of 19 minutes (interquartile range 15 - 24), and univariate analyses using Kruskal-Wallis testing found no association between prolonged PST and sending unit type (Emergency Department versus other), off-hours transports, or relatively frequent (at least monthly) use of HEMS ( p for all comparisons > 0.64). Outlier PSTs, defined a priori as those exceed ing the median by at least a half-hour, were found in 12% of all cases. These data could be useful as a starting point for system planning and benchmarking efforts in regionalized systems of acute cardiac care.