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Secondary transfers by helicopter emergency services for thrombectomy in rural England: a feasibility study (updated)

Lookup NU author(s): Hannah LumleyORCiD, Dr Darren FlynnORCiD, Dr Diarmuid CoughlanORCiD, Dr Peter McMeekin, Professor Gary Ford, Professor Dawn Craig, Stephen Rice, Professor Phil White

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Abstract

Introduction: England has 10 small (serving population<200,000) and remote (with transfer via Ground Based Ambulance (GBA) to thrombectomy centres exceeding 60 minutes) hospitals with Hyper-Acute Stroke Units (HASUs) where it is cost effective to provide secondary transfer via Helicopter Emergency Services (HEMS). The use of HEMS could decrease stroke-related disability by increasing thrombectomy provision to eligible patients. We identified characteristics of HEMS relevant to their utilisation to improve thrombectomy provision for these geographical areas. Method: HEMS encompassing 10 identified ‘‘small and remote’’ hospitals were asked to complete an online survey. Descriptive analysis was undertaken to assess operations, existing service provision, willingness to provide secondary transfers for thrombectomy and changes necessary to implement this development. Results: Responses were received from 9/9 HEMS. All were willing to provide secondary transfers. Services had a median of 2 helicopters (range 1–3). HEMS operated median 14h per day (07:00-21:30), with extensions to operational hours planned for 2/9. Median response time from notification to takeoff was 4 minutes and the cost per mission was £2750 (£2500-£3500). To deliver transfer for thrombectomy robustly, 3/9 HEMS indicated additional funding and/or organisational changes would be required. Conclusion: HEMS respondents considered use of HEMS for secondary transfers for thrombectomy from remote locations in England appropriate and deliverable. Use of HEMS would facilitate increased thrombectomy provision to eligible patients and improve equity of access to small, remote populations. However, additional funding and organisational changes were considered necessary to deliver robust HEMS thrombectomy transfer provision.


Publication metadata

Author(s): Lumley H, Flynn D, Coughlan D, McMeekin P, Ford GA, Craig D, Rice S, Burgess D, Balami J, Mawson A, White P

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: UK Stroke Forum

Year of Conference: 2019

Pages: 50-51

Print publication date: 01/12/2019

Online publication date: 03/12/2019

Acceptance date: 02/04/2018

ISSN: 2396-9873

Publisher: Sage Publications Ltd.

URL: https://doi.org/10.1177%2F1747493019882907

DOI: 10.1177%2F1747493019882907

Series Title: International Journal of Stroke


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