Hot Loading Reduces Time to Intervention for ST-segment Elevation Myocardial Infarction Patients Being Transferred by Helicopter

Objective: The aim of this study was to quantify the effect of helicopter hot loading on the time to percutaneous intervention (time-to-PCI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing interhospital transfer. Methods: We performed a retrospective cohort study using data from 2009 to 2014, looking at all patients who had an STEMI, were transferred from a single non-PCI hospital by helicopter emergency medical services, and who received PCI intervention at the PCI-capable hospital. Differences in loading method, flight details, and patient demographics were analyzed to measure the effectiveness of the intervention. Results: During the 5-year study period, 134 STEMI patients were transferred. Sixty-four were hot loaded (47.7%), and 70 were cold loaded. Patients who were hot loaded had a median reduction in interhospital transfer and time-to-PCI of 22.3 minutes from 91.0 minutes (interquartile range, 65-117 minutes) by cold load to 69.5 minutes (interquartile range, 47.5-91.5 minutes) by hot load. There was no increase in reported safety-related events during the hot load process. The median length of hospital stay was equivalent for both groups at 3 days. Conclusions: This protocol of helicopter hot loading STEMI patients presenting to a non-PCI hospital significantly reduced the median time of interhospital transfer and time-to-PCI without an increase in reported safety events.