Hawk Andrew, Marco Catherine, Huang Matt, Chow Bonnie
CareFlight Air and Mobile Services, Miami Valley Hospital/Premier Health, Dayton, OH; Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Kettering, OH.
Department of Emergency Medicine, Wright State University Boonshoft School of Medicine, Kettering, OH.
Air Med J. 2016 Nov-Dec;35(6):352-354. doi: 10.1016/j.amj.2016.05.007. Epub 2016 Jul 1.
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.