Stroke Management in Critical Care Transport Medicine: A Consensus Statement

The prehospital care of patients with acute ischemic stroke (AIS) is fraught with many challenges. Knowledge gaps within the prehospital care of patients with AIS contribute to inconsistent practices regarding diagnosis, pre-intervention positioning during transport, evaluation for stroke mimics, optimal patient destination, and hemodynamic management. The Air Medical Physician Symposium Lite held in Salt Lake City, Utah, gave experts in the field of critical care transport medicine (CCTM) a venue to discuss the current and optimal states of the prehospital patient with AIS.

The Air Medical Physician Symposium Lite was held on November 4, 2024, in Salt Lake City, Utah. Participants included international CCTM professionals. Attendees completed a survey on best practices, knowledge gaps, barriers to translation, and research priorities related to in-flight sedation and agitation protocols. The survey results informed lectures and panel discussions, followed by electronic audience voting to rank priority items.

The analysis reveals significant challenges such as limited accuracy of AIS identification tools, unclear destination protocols, and conflicting guidelines for hemodynamic management. Effective blood pressure management in the prehospital setting and the impact on air medical transport on the outcome of patients with AIS remain the top research priorities.

This statement underscores the need for additional future studies and standardized guidelines in CCTM, emphasizing improved diagnostic tools, clear destination protocols, and evidence-based hemodynamic management to enhance outcomes for patients with AIS during critical care transport.