Use of a field-to-stroke center helicopter transport program to extend thrombolytic therapy to rural residents.
OBJECTIVE
Giving stroke victims who reside outside communities with hospitals that can administer tissue plasminogen activator (rtPA) access to thrombolytic therapy is a challenge. Helicopter transport to a stroke center is a potential way to make rtPA available to these communities. We examined the experience of the Shands-Jacksonville Acute Stroke Transport Program, a field-to-stroke center helicopter transport program that serves rural counties in the northeastern Florida/southeastern Georgia region.


METHODS
Prospectively collected data of 111 consecutive helicopter transports to Shands-Jacksonville, from an 11-county region, over a 3-year period were reviewed.


RESULTS
Eighty-five patients (76%) had a cerebrovascular event. Forty-seven patients (42%) had an ischemic stroke, 19 (17%) had a transient ischemic attack, and 19 (17%) had a hemorrhagic stroke. Thrombolytic therapy was administered to 18 ischemic stroke patients (38%), with 15 being treated intravenously. Three patients who arrived beyond the 3-hour window were treated intra-arterially. Average field-to-hospital distance for all patients was 29.4 miles (range, 11 to 90 miles). Most patients (n=65) arrived within 135 minutes from symptom onset.


CONCLUSIONS
A helicopter-based transport system can link a rural region to a stroke center and promote access to thrombolytic therapy.
Silliman
Scott L
SL
Department of Neurology, University of Florida, Jacksonville, USA. scott.silliman@jax.ufl.edu
Quinn
Barbara
B
Huggett
Vicki
V
Merino
José G
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005431:Florida; D005845:Georgia; D006297:Health Services Accessibility; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D012041:Regional Medical Programs; D012189:Retrospective Studies; D019035:Rural Health Services / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors
D005343:Fibrinolytic Agents