Abstract Background and aims Pre-hospital triage and the mode of transport to an intervention center remain highly discussed. This study aimed to evaluate the efficacy of primary air transport triage to a Comprehensive Stroke Center (CSC) based on telephone-assessed FAST+ positivity. Methods The primary inclusion criterion was primary air transport to a CSC. There were three indication criteria for air intervention: 1) Location of emergency service intervention was located outside the district of a city with a stroke center; 2) The patient met FAST+ positivity (or FAST positivity at the dispatcher's discretion), assessed by the emergency medical dispatcher solely based on a telephone description; 3) The patient was fully independent (pre-stroke functional status). Results A retrospective analysis included 106 consecutive patients. All patients were FAST-positive based on the dispatcher's telephone call with a layperson on-site. AIS was diagnosed in 68 patients (64%); of these, 72% underwent recanalization treatment (68% intravenous thrombolysis, 25% mechanical thrombectomy). Another 22 patients (21%) had other severe diagnoses (hemorrhagic stroke, aortic dissection, myocardial infarction). Based on the telephone dispatch, 86 patients were FAST+ positive, with AIS diagnosed in 72% of these cases. Within the FAST+ positive AIS group, 77% received recanalization therapy. Other significant diagnoses were present in 16% of patients. Primary air transport was found to be justified in 91% of cases. Conclusions Telephone-assisted identification of FAST+ positivity can serve as a highly effective indication criterion for air transport. However, simple FAST positivity combined with judicious dispatcher discretion showed only marginally lower efficacy. Conflict of interest Bilik Jan: nothing to disclose, Cernik David: nothing to disclose
Bilík et al. (Fri,) studied this question.