Thrombolytic Care During Inter-hospital Transfer

The purpose of our study is to evaluate the effect of air ambulance transport on patients
presenting with an ischemic stroke and receive tissue plasminogen activator (rtPA). Primary
outcome will be the evaluation of air ambulance transfer and if it leads to protocol
violations or significant delays in therapy. Protocol violations include inaccurate dosing or
preparation at the outside hospital, uncontrolled blood pressure before and during the
flight, unnecessary medication administration before and during the flight and adverse events
(intracranial bleeding, allergic reaction) associated with transfer process. Additional
evaluation will include the effects of vibration of the air ambulance and its effects on the
lytic activity of rtPA. rtPA is not supposed to be significantly agitated after it is
prepared in solution and there is significant vibration and agitation during air ambulance
transfer.

Inclusion Criteria:

- Patients who received tissue plasminogen activator for acute ischemic stroke

- presented directly to comprehensive stroke center or were transferred by our air
ambulance service

Exclusion Criteria:

- Transferred by another air ambulance service or ground ambulance