title: Use of a field-to-stroke center helicopter transport program to extend thrombolytic therapy to rural residents.
abstract: 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.
authors.affiliation: Department of Neurology, University of Florida, Jacksonville, USA. scott.silliman@jax.ufl.edu
authors.forename: Scott L
authors.initials: SL
authors.lastname: Silliman
authors.forename: Barbara
authors.initials: B
authors.lastname: Quinn
authors.forename: Vicki
authors.initials: V
authors.lastname: Huggett
authors.forename: José G
authors.initials: JG
authors.lastname: Merino
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents