Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 11, November, p. 1495–1505

doi: 10.17219/acem/109456

Publication type: original article

Language: English

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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

Arkadiusz Wejnarski1,A,B,C,D,E,F, Piotr Leszczyński1,E, Stanisław Świeżewski2,C, Marcin Podgórski2,B, Michał M. Farkowski3,E, Maciej Sterliński4,E, Mariusz Panczyk5,C, Joanna Gotlib5,C, Daniel Rabczenko6,B, Robert Gałązkowski2,F

1 Institute of Health Sciences, Faculty of Medical and Health Sciences, Siedlce University of Natural Sciences and Humanities, Poland

2 Department of Emergency Medical Services, Faculty of Health Science, Medical University of Warsaw, Poland

3 Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warszawa, Poland

4 Clinic of Cardiac Arrhythmias, Institute of Cardiology, Warszawa, Poland

5 Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Poland

6 National Institute of Public Health – National Institute of Hygiene, Warszawa, Poland

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.
Conclusion. 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.

Key words

acute myocardial infarction, Helicopter Emergency Medical Service, aeromedical transport, patient with trauma

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