The impact of helicopter emergency medical service on acute ischemic stroke patients: A systematic review

Abstract

Background: Helicopter emergency medical services (HEMS) is commonly elected transport for acute ischemic stroke (AIS) known as a time-critical illness.

Aim: To conduct a systematic review in order to explore the HEMS impact on healthcare status, process and outcome measures for AIS patients.

Methods: A systematic search was conducted of PubMed, Medline, CINAHL, Cochrane Library and Google Scholar. The gray literature and reference lists of included articles were also searched. Thirty studies met inclusion criteria.

Results: Using Donabedian's framework, two studies focused on the impact on healthcare structure, twenty-three explored the impact on process measures, and five focused on clinical outcomes. HEMS structure implications could not be assessed due to insufficient studies. HEMS showed no significant outcome benefit compared to ground emergency medical services (EMS) and the impact on process measures was ambiguous.

Conclusions: HEMS necessity varied considerably between studies. More robust studies are needed for detection of the most suitable use of HEMS in AIS.

Keywords: Acute ischemic stroke; Air transfer; Cerebrovascular accident; Ground emergency medical service; Helicopter emergency medical service.