{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:21:32Z","timestamp":1789568492691,"version":"build-2803163510"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009287","name":"NSW Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009287","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Although guidelines recommend angiography and coronary intervention occur within 24\u2009h of thrombolysis when percutaneous coronary intervention (PCI) is not available within 120\u2009min, this target is difficult to achieve in rural and remote areas of New South Wales (NSW), Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this is secondary analysis we examine the impact of extending the existing 90\u2010min road transport limit for patients in rural and remote areas of western NSW who have received initial treatment for ST\u2010elevation myocardial infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient cohort consisted of 86 patients who were transported by road ambulance with transport times more than 90\u2009min. Adverse events occurred in 20% of patient transports and rates were similar in patients transported directly from the scene or from a community hospital. The most common adverse events were hypotension and bradycardia. There was one cardiac arrest, four minor bleeding events and no major bleeding events. The main treatments provided were morphine analgesia, nitrates and anti\u2010emetic medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The primary study showed a significant reduction in time from first clinical contact to arrival at the PCI hospital. In this secondary analysis, we demonstrate that the rate of adverse events during long\u2010distance road transport is low, the adverse events are mostly minor in nature and are within the scope of paramedic practice to manage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.70005","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:13:58Z","timestamp":1738300438000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adverse events and paramedic interventions during extended ground transport in a rural pharmaco\u2010invasive <scp>STEMI<\/scp> program"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3896-6663","authenticated-orcid":false,"given":"Steven C","family":"Faddy","sequence":"first","affiliation":[{"name":"Research and Evaluation, NSW Ambulance  Sydney Olympic Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Edwards","sequence":"additional","affiliation":[{"name":"Clinical Programs, NSW Ambulance  Sydney Olympic Park New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Luscombe","sequence":"additional","affiliation":[{"name":"School of Rural Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Ryan","sequence":"additional","affiliation":[{"name":"Cardiology CNC, Orange Health Service, Western NSW Local Health District  Dubbo New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Arnold","sequence":"additional","affiliation":[{"name":"Orange Health Service, Western NSW Local Health District  Dubbo New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2016.06.1213"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2015.07.019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2016.06.789"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.057538"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000121424.76486.20"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac661"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Paramedic interventions and adverse patient events during prolonged interfacility ground transport in a \u201cdrip and ship\u201d pharmacoinvasive model of STEMI care","volume":"28","author":"Sibley AK","year":"2023","journal-title":"Prehosp. Emerg. Care"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2024.2342569"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2024.07.016"},{"key":"e_1_2_8_12_1","volume-title":"Epidemiology and Management of ST\u2010Elevation Myocardial Infarction (STEMI) in Rural and Remote Patients in NSW","author":"Faddy S","year":"2023"}],"container-title":["Emergency Medicine Australasia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1742-6723.70005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T23:26:04Z","timestamp":1741735564000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1742-6723.70005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/1742-6723.70005"],"URL":"https:\/\/doi.org\/10.1111\/1742-6723.70005","archive":["Portico"],"relation":{},"ISSN":["1742-6731","1742-6723"],"issn-type":[{"value":"1742-6731","type":"print"},{"value":"1742-6723","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]},"assertion":[{"value":"2024-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70005"}}