Air Med J. 2026 May-Jun;45(3):185-190. doi: 10.1016/j.amj.2026.01.001. Epub 2026 Jan 30.
ABSTRACT
OBJECTIVE: In Norway, helicopter emergency medical services (HEMS) are dispatched for suspected cerebral stroke if intravenous thrombolysis may be administered within 4.5 hours of symptom onset, and it reduces time of transport by ≥30 minutes compared with basic emergency medical services (EMS). However, cerebral stroke presents with heterogeneous symptoms; therefore, identification by emergency dispatchers can be difficult. The primary outcome was the positive predictive value for stroke among patients with suspected stroke for whom HEMS was dispatched. Secondary outcomes included rates of prehospital interventions, quality indicator fulfillment, and rates of selected in-hospital interventions within time limits.
METHODS: We conducted a retrospective cohort study using aggregated prehospital and in-hospital data from an electronic patient journal. It included 161 primary missions from the HEMS base in Trondheim, where HEMS was deployed on the index criterion of cerebral stroke set by the Emergency Medical Coordination Center between 2022 and 2024.
RESULTS: Of all primary missions, 14% (n = 162) were because of suspected stroke. A total of 75 patients (47%) were diagnosed with having stroke, whereas 12 (7%) were diagnosed with having transient ischemic attack. In 7% of cases, an advanced intervention that requires a physician was performed. A total of 40 patients (25%) received intravenous thrombolysis and/or endovascular thrombectomy.
CONCLUSION: Stroke was confirmed in 47% of HEMS dispatches for suspected stroke. HEMS likely reduced transport time by ≥30 minutes for most patients, whereas prehospital advanced interventions were rarely performed. Further studies on index use and comparative studies of HEMS and EMS dispatches could help strengthen patient selection and optimize resource utilization.
PMID:42069352 | DOI:10.1016/j.amj.2026.01.001