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

Abstract

ObjectiveThe 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. MethodsWe 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. ResultsDuring 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. ConclusionsThis 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.