Helicopter transfer offers a potential benefit to patients with acute stroke

• Published in: Stroke (1970) Vol. 30; no. 12; pp. 2580 - 2584
• Main Authors: CONROY, M. B, RODRIGUEZ, S. U, KIMMEL, S. E, KASNER, S. E
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.12.1999; American Heart Association, Inc
• Subjects: Air Ambulances - statistics & numerical data; Biological and medical sciences; Female; Fibrinolytic Agents - therapeutic use; Health Care Surveys; Humans; Male; Medical sciences; Middle Aged; Neurology; Patient Satisfaction; Patient Transfer - methods; Patient Transfer - statistics & numerical data; Stroke - drug therapy; Tissue Plasminogen Activator - therapeutic use; Vascular diseases and vascular malformations of the nervous system; Human; Nervous system diseases; Stroke; Helicopter; Medical transport; Acute; Cardiovascular disease; Cerebral disorder; Vascular disease; Emergency department; Treatment; Central nervous system disease; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.30.12.2580

Rapid transport of patients to specialized centers is widely used in the management of myocardial infarction, trauma, and more recently, acute stroke. We evaluated the role of helicopter transportation as it relates to the availability of acute stroke therapies and patients' perceptions of care. We reviewed records of all patients transferred to a university hospital within 24 hours of stroke onset from January 1996 to December 1997. Data were collected on demographics, neurological deficit, treatment, and outcome. In addition, a questionnaire was sent to all patients with items about perceived reasons for helicopter transfer, expected and actual treatment, outcome, and overall impression. Helicopter transfer was used for 73 stroke patients. Before transfer, 8 patients (11%) received tissue plasminogen activator (tPA). On arrival, no patient received tPA, 38 patients (52%) were enrolled in acute stroke studies, and 35 patients (48%) received no specific medication. All but 2 patients were managed in a specialized stroke unit. Of the 35 patients who received no specific therapy, 24 (69%) were ineligible for treatment or study enrollment owing to 1 or more exclusion criteria, but rarely (3%) because of time. Of the 45 respondents to the survey, most (84%) were transferred at the suggestion of the physician at the originating hospital because of a possible treatment that was unavailable there. Most patients (93%) believed that there was a benefit from emergent helicopter transfer to a stroke center, although 40% of respondents received no specific therapy. Interhospital transfer by air may benefit a substantial number of acute stroke patients by offering potential therapies and intensive management not available elsewhere.