Safety of long distance aeromedical transport of the cardiac patient: a retrospective study.
BACKGROUND
The purpose of this study is to provide data regarding the safety of long distance air transport of cardiac patients, establish a time frame for safe transport, and assess current guidelines for postmyocardial infarct (post-MI) transport.


METHODS
Retrospective analysis of all long distance aeromedical transports performed by Montreal-based Skyservice Lifeguard from January 1 to October 1, 1998.


RESULTS
109 cardiac patients were transported; 83 by air ambulance (AA), and 26 commercially (C). Diagnoses included MI (63%), unstable angina (31%), congestive heart failure (21%), and arrhythmia (17%). Patients were transported a mean of 7 d (AA) vs. 13.7 d (C) after presentation. Inflight complications, occurring in 10% of AA and 4% of C flights, were minor (chest pain, desaturation, and hypotension), and resolved quickly. In 51 post-MI AA patients, complication rate for transport > 7 d after admission was 0% (vs. 14% <7 d), and > 72 h after last chest pain was 6% (vs. 18% <72 h). Comparing uncomplicated (n = 25) vs. complicated (n = 26) MI reveals fewer complications for transport 0-3 d (13% vs. 50%) and 4-7 d (9% vs. 14%) after admission, and 48-72 h after last chest pain (0% vs. 100%).


CONCLUSIONS
AA transport of cardiac patients can safely be performed earlier than guidelines for C flights. AA transport appears safe after complicated MI by day 7 or > 72 h chest pain free, and after uncomplicated MI by day 3 or > 48 h chest pain free. Future guidelines for aeromedical transport post-MI should distinguish between C and AA.
Essebag
V
V
Department of Cardiology, McGill University Health Centre, Montreal, Canada. esseb97@med.mcgill.ca
Lutchmedial
S
S
Churchill-Smith
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000592:standards*; D003327:Coronary Disease / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014187:Transportation of Patients / Q000379:methods*; D014218:Triage