Helicopter Scene Response for Stroke Patients: A 5-Year Experience

• Published in: Air medical journal Vol. 35; no. 6; pp. 352 - 354
• Main Authors: Hawk, Andrew, MD, Marco, Catherine, MD, Huang, Matt, MD, Chow, Bonnie, BS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2016
• Subjects: Aged; Aged, 80 and over; Air Ambulances; Emergency; Emergency Medical Services; Female; Fibrinolytic Agents - therapeutic use; Health administration; Humans; Internal Medicine; Male; Middle Aged; Neurosurgical Procedures - methods; Retrospective Studies; Stroke - therapy; Thrombolytic Therapy; Tissue Plasminogen Activator - therapeutic use; Triage
• ISSN: 1067-991X; 1532-6497
• DOI: 10.1016/j.amj.2016.05.007

Abstract Objective The purpose of this study was to examine the usefulness of an emergency medical service (EMS)-requested air medical helicopter response directly to the scene for a patient with clinical evidence of an ischemic cerebrovascular accident (CVA) and transport to a regional comprehensive CVA center. Methods CareFlight, an air medical critical care transportation service, is based in Dayton, OH. The 3 CareFlight helicopters are geographically located and provided transport to all CVA scene patients in this study. A retrospective chart review was completed for all CareFlight CVA scene flights for 5 years (2011-2015). A total of 136 adult patients were transported. EMS criteria included CVA symptom presence for less than 3 hours or awoke abnormal, nonhypoglycemia, and a significantly positive Cincinnati Prehospital Stroke Scale. Results The majority of patients (75%) met all 3 EMS CVA scene criteria; 27.5% of these patients received peripheral tissue plasminogen activator, and 9.8% underwent a neurointerventional procedure. Conclusion Using a 3-step EMS triage for acute CVA, air medical transport from the scene to a comprehensive stroke center allowed for the timely administration of tissue plasminogen activator and/or a neurointerventional procedure in a substantive percentage of patients. Further investigation into air medical scene response for acute stroke is warranted.