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

Area of Science:

• Emergency Medicine
• Neurology
• Transportation Science

Background:

• Acute ischemic stroke (cerebrovascular accident - CVA) requires rapid intervention for optimal patient outcomes.
• Timely access to specialized stroke centers is crucial for advanced treatments.
• Prehospital emergency medical service (EMS) plays a vital role in initiating stroke care.

Purpose of the Study:

• To evaluate the effectiveness of direct-to-scene air medical helicopter transport for patients with suspected ischemic cerebrovascular accidents (CVAs).
• To assess the utility of this rapid response model in facilitating timely treatment at a comprehensive stroke center.

Main Methods:

• A retrospective chart review of 136 adult patients transported by CareFlight air medical service between 2011-2015.
• Inclusion criteria included clinical evidence of CVA, symptom onset <3 hours or awoke abnormal, normal glucose, and a positive Cincinnati Prehospital Stroke Scale.
• Patients were transported directly from the scene to a regional comprehensive CVA center.

Main Results:

• The majority of patients (75%) met all three EMS CVA scene criteria.
• Of these patients, 27.5% received intravenous tissue plasminogen activator (tPA).
• A notable 9.8% of patients underwent neurointerventional procedures.

Conclusions:

• Direct air medical scene response for acute ischemic stroke (CVA) enables timely administration of critical treatments.
• A three-step EMS triage system effectively identifies patients benefiting from this rapid transport model.
• Further research is recommended to explore the full potential of air medical services in acute stroke management.