Can a screening tool safely identify low risk cardiac patients to be transported with primary care flight paramedics?. (September 2020)

• Record Type: Journal Article
• Authors: Godbout, Justin; Moore, Sean W.; Sawadsky, Bruce; Pan, Andy; Vaillancourt, Christian
• Editors: Tien, Homer; MacDonald, Russell
• Is Part Of: CJEM. Volume 22(2020)Supplement 2
• Page Start: S38
• Page End: S44
• Publication Date: 2020-09
• Subjects: Screening tool, -- cardiac, -- primary care paramedic, -- air-medical transport, -- adverse event, -- prehospital care; Emergency Treatment -- Periodicals; Emergency Medicine -- Periodicals; Emergency medical services -- Canada -- Periodicals; Medical emergencies -- Canada -- Periodicals; Emergency medical services; Medical emergencies; Canada; Periodicals; 616.02505
• DOI: 10.1017/cem.2019.459
• Languages: English
• ISSNs: 1481-8035

Abstract

ABSTRACT: Objectives: We aimed to determine the rate of adverse events during interfacility transport of cardiac patients identified as low risk by a consensus-derived screening tool and transported by primary care flight paramedics (PCP(f)). Methods: We conducted a health records review of adult patients diagnosed with a cardiac condition who were identified as low risk by the screening tool and transported by PCP(f). We excluded patients transported by an advanced care crew, those accompanied by a clinical escort from hospital, and those transported from a scene call, by rotary wing or ground vehicle. We recorded patient and transportation parameters using a piloted-standardized collection tool. We defined adverse events during transport a priori. We report descriptive statistics using mean (standard deviation), [range], (percentage). Results: We included 400 patients: mean age 66.9 years old, 66.5% male. Mean transport duration was 136.2 (74.9) minutes. Most common comorbidities were hypertension (50.3%) and coronary artery disease (39.5%). Most transports originated out of Northern Ontario and were for cardiac catheterization (61.8%) or coronary artery bypass grafting (26.8%). Overall, the adverse event rate was low (0.3%), with no serious event such as cardiac arrest, death, or airway intervention. Conclusions: A screening tool can identify cardiac patients at low risk for clinical deterioration during air-medical transport. We believe patients screened with this tool can be transported safely by a PCP(f) crew, leading to potentially significant resource savings.