title: Stroke and Helicopter Emergency Medical Service Transports: An Analysis of 25,332 Patients.
abstract: OBJECTIVE
  Helicopter emergency medical services (HEMS) are effective in time-sensitive illnesses, including stroke. Intravenous tissue plasminogen activator is beneficial for ischemic stroke within 4.5 hours of onset. This study analyzed the largest repository of US HEMS electronic medical record data characterizing demographic and logistical trends during stroke center accreditation. This study developed a methodology to aggregate, analyze, and report data from multiple providers.
  
  
  METHODS
  This is a descriptive study of aggregate, deidentified data from 67 US providers from 2004 to 2011. Retrospective data including age, ethnicity, total transport time, mission type, and locality were analyzed. The effect of primary stroke center (PSC) designation was assessed for 2011.
  
  
  RESULTS
  A total of 25,332 patients were transported for "stroke." Stroke increased from 1.4% to 3.9% during the study. Ninety-six percent of transports arrived at definitive care within 2 hours. Seventy-two percent of transports were "interfacility," and 58% were from "rural" or "super-rural" localities. Seventy-nine percent of 2011 transports were to PSCs. Ethnicity and age were significant barriers to transport to PSCs (P < .001).
  
  
  CONCLUSIONS
  HEMS has increased access to stroke care for super-rural, rural, and urban communities offering timely transport within the treatment window if symptoms are recognized within 2.5 hours of onset. This study created a methodology for future multicenter aggregate data studies.
authors.affiliation: Golden Hour Data Systems, Incorporated, San Diego, CA.
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Hutton
authors.affiliation: Golden Hour Data Systems, Incorporated, San Diego, CA.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Fleming
authors.affiliation: Air Medical Research Institute, University of Utah, Division of Emergency Medicine, Salt Lake City, UT.
authors.forename: Scott
authors.initials: S
authors.lastname: Youngquist
authors.affiliation: Golden Hour Data Systems, Incorporated, San Diego, CA; Air Medical Research Institute, University of Utah, Division of Emergency Medicine, Salt Lake City, UT. Electronic address: Kevin@GoldenHour.com.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Hutton
authors.affiliation: Golden Hour Data Systems, Incorporated, San Diego, CA.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Heiser
authors.affiliation: Air Medical Research Institute, University of Utah, Division of Emergency Medicine, Salt Lake City, UT.
authors.forename: Erik D
authors.initials: ED
authors.lastname: Barton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors; D014187:Transportation of Patients / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult