Early tPA Treatment and Aeromedical Transport of Patients with Acute Myocardial Infarction

Academic Article

Abstract

  • Over a 2‐year period 192 patients with acute myocardial infarction (AMI) were transported by helicopter and treated with recombinant tissue‐plasminogen activator (tPA). All patients were entered into the Thrombolysis in Myocardial Infarction‐Phase II (TIMI II) trial. Eighty‐two of these patients were treated with tPA after aeromedical transport to a tertiary care center. One hundred ten patients had tPA treatment initiated by the flight crew prior to transport. The flight crews initiated therapy 28 ± 11 minutes after arrival at the sending hospital. The post‐flight treated patients received the tPA bolus 82 ± 20 minutes after arrival at the sending hospital (P < .0001), and 41 ± 18 minutes after arrival at the receiving hospital (P < .0001). Based on enzyme and electrocardiographic changes, all patients in the study had a confirmed diagnosis of AMI before discharge. Patients with inferior myocardial infarction (MI) treated with tPA in‐flight were more likely to suffer from bradycardia and hypotension requiring atropine injection during transport than the post‐flight treated patients or inflight treated patients with anterior MI. There was no in‐flight mortality in either group. Our experience indicates that patients with AMI can be transported safely during tPA therapy. Also, a trained team whose sole responsibility is the early evaluation and initiation of therapy in a patient with AMI can function as accurately and significantly more rapidly than tertiary care emergency department and ICU personnel following identical protocols. Copyright © 1991, Wiley Blackwell. All rights reserved
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    Digital Object Identifier (doi)

    Author List

  • SPANGLER DE; ROGERS WJ; GORE JM; GRIFFITH M; MASKE LE; MORGAN TE; CORRAO J
  • Start Page

  • 81
  • End Page

  • 89
  • Volume

  • 4
  • Issue

  • 2