2019 Volume 24 Issue 2 Pages 116-121
Air ambulances both shorten the delivery time it takes to get patients to a hospital and contribute to the early initiation of medical treatment by the attending physicians. We have created acute stroke diagnosis/treatment procedures that are specialized for air ambulances together with an emergency department, and herein we examined the efficacy of these procedures. Our hospital, has used air ambulances in acute stroke care since April 2011. In our procedure, the air ambulance's flight staff in contact with the hospital confirms the patient's Cincinnati Prehospital Stroke Scale (CPSS) score and the last known time that the patient was observed to be well; the flight staff also collects blood from a secured venous infusion line and conveys the patient information to our hospital staff. On arrival at the hospital, the waiting staff obtains a detailed neurological evaluation and takes the patient directly to a computed tomography room for a CT examination. Other staff simultaneously transports the blood samples to the specimen laboratory. Stroke physicians select the subsequent treatment based on imaging and neurological findings. We examined the proportions of stroke subtypes and the use of intravenous recombinant tissue plasminogen activator (rt‒PA) treatment observed from April 2011 to March 2017. Of the 3,453 air ambulance transfers during the observation period, 531 patients (～15%) were diagnosed as having 'any' type of acute stroke, and 92 patients were treated with intravenous rt‒PA. Our acute stroke diagnosis and treatment procedures using air ambulances was observed to achieve rapid and adequate treatment for stroke patients.
