title: Air transport of patients with unstable aortic aneurysms directly into operating rooms.
abstract: OBJECTIVE
  The purpose of this study was to describe an air transport service's protocol for direct transport of patients with abdominal aortic aneurysm leak (AAAL) into receiving hospital operating rooms (ORs).
  
  
  METHODS
  This retrospective consecutive-case analysis examined AAAL patients undergoing nurse-paramedic Boston MedFlight (BMF) transport during 1999-2004, who were taken directly into ORs at four academic centers. BMF uses a rotating roster system to assign receiving hospitals when referring physicians have no preidentified receiving facility, but this practice may prolong patient transport or be associated with less diagnostic certainty, and thus more delay, at receiving hospitals. Thus, the study compared "Roster" versus "Non-roster" patients' time and outcome end points. Continuous nonparametric data (e.g., time intervals) were described with median and interquartile range (IQR). Chi-square and Kruskal-Wallis tests were used for univariate comparisons; regression analysis assessed dependent variables while adjusting for covariates (e.g., transport mileage).
  
  
  RESULTS
  There were 29 direct-to-OR transports, with median distance of 30 miles. All patients had AAAL diagnosis confirmed; 51.7% survived. System performance for end points was similar as assessed between Roster versus Non-roster patients.
  
  
  CONCLUSIONS
  Interfacility direct-to-OR transport of AAAL patients is feasible. Use of a roster system allows for timely transport facilitation for patients needing specialized care; roster patients achieve similar end points as did patients who had already-identified receiving hospitals upon air medical transport request.
authors.affiliation: Department of Emergency Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114-2696, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Shewakramani
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Thomas
authors.forename: Tim H
authors.initials: TH
authors.lastname: Harrison
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Gates
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances; D017544:Aortic Aneurysm, Abdominal; D001900:Boston; D006801:Humans; D009873:Operating Rooms; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States