Hot Loading Reduces Time to Intervention for ST-segment Elevation Myocardial Infarction Patients Being Transferred by Helicopter

• Published in: Air medical journal Vol. 38; no. 3; pp. 150 - 153
• Main Authors: Lubin, Jeffrey S., McCullum, Keane E.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2019
• Subjects: Air Ambulances; Female; Health administration; Humans; Male; Middle Aged; Patient Transfer - methods; Patient Transfer - statistics & numerical data; Retrospective Studies; ST Elevation Myocardial Infarction - therapy; Time Factors
• DOI: 10.1016/j.amj.2019.02.002
• EISSN: 1532-6497
• ISSN: 1067-991X

•Patients with myocardial infarction may need transfer to a percutaneous intervention (PCI)-capable center.•A shorter time to treatment results in improved patient outcomes.•Hot loading, loading the patient into the aircraft with the rotors spinning, is 1 method of decreasing the time needed to transfer a patient.•In this study, hot loading shortened the time to treatment for patients with myocardial infarction who required transfer to a PCI-capable center by an average of 22 minutes.•Although there was a decrease in handoff communication, there was no increase in adverse events during transport.
The aim of this study was to quantify the effect of helicopter hot loading on the time to percutaneous intervention (time-to-PCI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing interhospital transfer.
We performed a retrospective cohort study using data from 2009 to 2014, looking at all patients who had an STEMI, were transferred from a single non-PCI hospital by helicopter emergency medical services, and who received PCI intervention at the PCI-capable hospital. Differences in loading method, flight details, and patient demographics were analyzed to measure the effectiveness of the intervention.
During the 5-year study period, 134 STEMI patients were transferred. Sixty-four were hot loaded (47.7%), and 70 were cold loaded. Patients who were hot loaded had a median reduction in interhospital transfer and time-to-PCI of 22.3 minutes from 91.0 minutes (interquartile range, 65-117 minutes) by cold load to 69.5 minutes (interquartile range, 47.5-91.5 minutes) by hot load. There was no increase in reported safety-related events during the hot load process. The median length of hospital stay was equivalent for both groups at 3 days.
This protocol of helicopter hot loading STEMI patients presenting to a non-PCI hospital significantly reduced the median time of interhospital transfer and time-to-PCI without an increase in reported safety events.