Open AccessThe “Flying Intervention Team”: A Novel Stroke Care Concept for Rural Areas
Author(s) -
G. Hubert,
Frank Bernhard Kraus,
Christian Maegerlein,
Sabine Platen,
Benjamin Friedrich,
Hans-Ulrich Kain,
Thomas Witton-Davies,
Nikolai Hubert,
Claus Zimmer,
Philip M.W. Bath,
Heinrich J. Audebert,
R. Haberl
Publication year - 2021
Publication title -
cerebrovascular diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 104
eISSN - 1421-9786
pISSN - 1015-9770
DOI - 10.1159/000514845
Subject(s) - medicine , stroke (engine) , population , emergency medicine , acute stroke , intervention (counseling) , medical emergency , nursing , environmental health , emergency department , mechanical engineering , engineering
Background: Endovascular treatment of large vessel occlusion in acute ischemic stroke patients is difficult to establish in remote areas, and time dependency of treatment effect increases the urge to develop health care concepts for this population. Summary: Current strategies include direct transportation of patients to a comprehensive stroke center (CSC) (“mothership model”) or transportation to the nearest primary stroke center (PSC) and secondary transfer to the CSC (“drip-and-ship model”). Both have disadvantages. We propose the model “flying intervention team.” Patients will be transported to the nearest PSC; if telemedically identified as eligible for thrombectomy, an intervention team will be acutely transported via helicopter to the PSC and endovascular treatment will be performed on site. Patients stay at the PSC for further stroke unit care. This model was implemented at a telestroke network in Germany. Fifteen remote hospitals participated in the project, covering 14,000 km 2 and a population of 2 million. All have well established telemedically supported stroke units, an angiography suite, and a helicopter pad. Processes were defined individually for each hospital and training sessions were implemented for all stroke teams. An exclusive project helicopter was installed to be available from 8 a.m. to 10 p.m. during 26 weeks per year. Key Messages: The model of the flying intervention team is likely to reduce time delays since processes will be performed in parallel, rather than consecutively, and since it is quicker to move a medical team rather than a patient. This project is currently under evaluation (clinicaltrials NCT04270513).