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

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.

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.

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.

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.