Flying heart attack patients to hospital - even if they live in mainland Scotland - is being considered by the Scottish Ambulance Service.
It is thought airlifting some sufferers, rather than using roads, might allow them to receive the latest treatment, which must be delivered in a 90-minute time window.
In the future, all patients suffering severe heart attacks in the west of Scotland will be taken to one of two hospitals, bypassing other A&E departments.
This is so they can undergo an emergency angioplasty, where specially trained cardiologists re-open their blocked artery by inserting an inflatable balloon.
However, the treatment has to be given within an-hour-and-a-half of the onset of symptoms, raising the issue of how patients living further from the two centres - the Golden Jubilee National Hospital in Clydebank and Hairmyres Hospital in East Kilbride - would reach the experts in time.
Discussing this issue in his first interview since taking over as chief executive of the Scottish Ambulance Service, Kevin Doran, said: "It is an expensive thing to do, but if you think about a double-crewed ambulance driving four hours up and down, it might be better both in terms of patient care and the efficiency of the service to try and do more air transport."
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A study to test whether patients living more than 90 minutes away from the two hospitals by road could benefit from air transfer is being launched.
Mr Doran said: "We are taking a number of cases that have been land transfers and saying, let's see how many of them might have been suitable for an air transfer or if an air transfer would have made any difference."
The Scottish Ambulance Service currently has two planes and two helicopters which fly around 3000 missions a year. Most of their work involves transferring patients from islands to mainland hospitals and only 15 to 20% of cases are emergencies.
However the advent of emergency angioplasties could push this proportion up.
Mr Doran warned a number of factors had to be considered when using air transport, including where the aircraft could land and the weather.
"While flight time might be shorter, you are look at the whole journey time," he said.
"That is why we are working closely with other health boards to model the options."
A significant improvement in the time it takes ambulances to respond to emergency calls was also revealed by Mr Doran, who joined the service in November.
The Scottish Executive had set crews a target of reaching three-quarters of top priority calls within eight minutes by 2008. However, at the end of last year figures showed they were reaching 62.9% in time.
Mr Doran said they were now much closer to the goal, with 73% of category A calls reached inside the time limit. A minute has been shaved off the average response time since November, down to just under seven minutes.
Mr Doran praised ambulance service staff for the achievement. He said: "When I came here I think folk felt it was not do-able and what I think has changed is their confidence in getting to it."
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