Feasibility and safety of emergency interhospital transport of patients during early hours of acute myocardial infarction

The transfer of patients with acute myocardial infarction from community hospitals to tertiary care facilities for further intervention has become increasingly more frequent due to the emerging role of thrombolytic therapy and percutaneous transluminal coronary angioplasty. To assess the feasibility and safety of early transfer, a prospective analysis of 57 patients who were transported by ground ambulance or helicopter to the University of Massachusetts Medical Center, Worcester, for acute intervention during the early hours of myocardial infarction was conducted. Before transport, the majority (46 [81%]) of patients were having chest discomfort, 13 (23%) were hypotensive, and 12 (21%) were electrically unstable (defined as high-grade ventricular ectopia or nonsustained ventricular tachycardia). During transport, the majority (41 [72%]) continued to have some chest discomfort; however, only two (4%) remained hypotensive. Although five patients (9%) were electrically unstable during transport, the instability was considered noncritical. The distance traveled or the mode of transportation did not adversely impact on these clinical complications. All patients survived transport, and 53 patients (93%) were eventually discharged from the receiving hospital