Læknablaðið - 15.03.2010, Side 17

FRÆÐIGREINAR
RANNSÓKNIR
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Management of patients with STEMI transported with air-ambulance to
Landspitali University Hospital in Reykjavík
Introduction: A good outcome of patients presenting
with STEMI (ST-Segment Elevation Myocardial Infarction)
depends on early restoration of coronary blood flow.
Pre-hospital fibrinolysis is recommended if primary
percutaneous coronary intervention (PPCI) cannot be
performed within 90 minutes of first medical contact
(FMC). The purpose of this study was to study transport
times for patients with STEMI who were transported with
air-ambulance from the northern rural areas of lceland to
Landspitali University Hospital in Reykjavík, and to assess
if the medical management was in accordance with clinical
guidelines.
Materials and methods: Retrospective chart review
identified 33 patients with STEMI who were transported
with air-ambulance to Landspitali University Hospital in
Reykjavík during the years 2007 and 2008.
Results: The total time from first medical contact to arrival
at Landspitali University Hospital emergency room was 3
hours and 7 minutes (median). All patients received aspirin
and 26 (78.8%) received clopidogrel and enoxaparin. 16
patients (48.5%) received thrombolytic therapy in median
33 minutes after FMC and 15 patients had PPCI performed
in median 4 hours and 15 minutes after FMC. Estimated
PCI related delay was 3 hours and 42 minutes (median).
One patient died and one was resuscitated within 30
hospital days. Mean hospital stay was 6.0 days.
Conclusions: First medical contact to balloon time of less
than 90 minutes is impossible for patients with STEMI
transported from the northern rural areas to Landspitali
University Hospital in Reykjavik. Medical therapy was in
many cases suboptimal and PCI related delay too long.
Sigmundsson TS, Gunnarsson B, Benediktsson S, Gunnarsson GT, Duason S, Thorgeirsson G.
Management of patients with STEMI transported with air-ambulance to Landspitali University Hospital in Reykjavík. Icel Med J
2010; 96: 159-65
Keywords: Air-ambulance transport, rurat medicine, myocardial infarction, fibrinolysis, quality of care.
Correspondence: Þórir Svavar Sigmundsson, thorir.sigmundsson@karolinska.se
Barst: 18. september 2009, - samþykkt til birtingar: 11. janúar 2010
Hagsmunatengsl: Engin
LÆKNAblaðið 2010/96 165
ENGLISH SUMMARY