Medevac the Doc, Not the Patient, for Speedy Endovascular Stroke Tx

Interesting. But still does nothing to stop these 5 causes of the neuronal cascade of death in the first week. You need to fix both the immediate problem of plugged arteries and the continuing dying neurons. Don't pat yourself on the back for fixing one small piece of the problem. A comprehensive solution is needed.
https://www.medpagetoday.com/Cardiology/Strokes/65020?

Initial experience suggests strategy is faster, feasible, cost-effective

• by Nicole Lou
  Reporter, MedPage Today/CRTonline.org May 04, 2017

Stroke patients at a hospital without a staff neurointerventionalist may benefit from having one helicoptered in, researchers showed in a proof-of-concept case.
When a patient needing endovascular treatment presented at one such primary stroke center with onsite angiographic facilities in Maryland, a logistical plan it had worked out with an in-network comprehensive stroke center 39.4 miles away was activated.
Nine minutes after completing MRI and MR angiography and 59 minutes after stroke onset, the hub hospital's neurointerventionalist was called. It then took 25 minutes to consult the Medevac service, get weather clearance, and confirm that there were no other emergencies to attend to before the hospital had the doctor on the helipad for the 19-minute helicopter ride to the patient's location.
Total time from decision-to-treat to groin puncture was 43 min; groin closure was achieved by minute 77, reported researchers led by Ferdinand K. Hui, MD, of Johns Hopkins Hospital in Baltimore, in the Journal of Neurointerventional Surgery.
"These times are competitive with single institution times to treatment without transfer, which should be maximally expeditious," they suggested.
Symptom onset-to-groin puncture time was 119 minutes; time elapsed from symptom onset to groin closure was 153 minutes.
The patient had a large vessel occlusion and an NIH Stroke Scale score greater than 8.
Arguing that this approach could be practical -- and not too costly -- in the real world, Hui and colleagues wrote that helicopter transfer of the neurointerventionalist cost one-fifth of similar transport for a patient.
"The direct cost differential between transporting a physician versus a patient will vary between regions and hospital networks. However, transporting a physician would most probably offer a many-fold reduction in transport cost compared to transporting a stroke patient, as the cost of nursing care, monitoring equipment and other staffing would be eliminated. Flying a physician is also less time intensive as the hand-off protocols and line checks necessary for moving a patient are completely obviated."
"From the U.S. healthcare perspective, given the overall cost-effectiveness of endovascular therapy, the Helistroke approach will result in both immediate direct cost savings and also in indirect long-term cost-benefit associated with favorable stroke outcome," the authors suggested.

Hui's group had no competing interests listed.

• Primary Source

  Journal of Neurointerventional Surgery

  Source Reference: Hui FK, et al "Helistroke: neurointerventionalist helicopter transport for interventional stroke treatment: proof of concept and rationale" J Neurointerv Surg 2017; DOI: 10.1136/neurintsurg-2017-013050.