Cardiovascular disease (CVD) in the Norwegian Arctic. Air ambulance operations 1999-2009 and future challenges in the region

Background. Air ambulance operations in the Arctic have to deal with remote locations, long distances, rough weather conditions, seasonable darkness, and almost no alternative for landing. Despite these challenges, people expect high quality, specialist health care. Objective. This study aimed to analyse air ambulance operations due to cardiovascular disease (CVD) in the Arctic and employ the result as an instrument for future suggestions. Melting ice in the Arctic Sea opens new prospects for shipping, adventures, and oil/gas industry. Material and methods. In February 2010 all air ambulance operations performed in the Arctic during the period 1999 to 2009 were analysed. The population of this study covered patients with CVD. The state of emergency, state of seriousness (the National Advisory Committee on Aeronautics (NACA) scale was used), flight time, destination, and flying time were the main outcome measures. A total of 45 patients (myocardial infarction 31, angina pectoris 11, and heart failure 4 patients) were identified. There were 39 Norwegians and 6 people of other nationalities. The mean age was 57 years (range 43-83 years) Results. Thirteen cardiac incidents occurred in June and July. Most cases (26 patients) were considered urgent or emergent, and the mean NACA score was 4 (range 3-6). The adjusted female/male ratio was 0.222, and the median flying time (one way) was 3 h 25 min (range 1 h-6 h 40 min). Four flights were delayed, and one fifth of patients were transported during the night (midnight to 8.00 AM). Conclusions. Air ambulance operations in the Arctic experience significant challenges. In the near future more shipping and polar adventure operations together with new oil and gas installations will increase the demand for health care support. Telemedical installations onboard vessels and rigs will be important for remote consultation and treatment