Aeromedical Transfer of Patients for Emergency Clot Retrieval - The Western Australian Experience
Royal Flying Doctor Service Western Operations, Jandakot, Australia
Andy Hooper is an Emergency Physician by trade, now working full time as a Retrieval Physician for the Royal Flying Doctor Service, Western Operations.
Emergency clot retrieval (ECR) is a developing interventional therapy for patients suffering from acute stroke with large vessel occlusion (LVO). Recent trials (DAWN, DEFUSE-3) indicate better functional neurological outcomes for patients with LVO who undergo ECR, in addition to standard medical therapy, provided ECR can be administered within appropriate an time frame.
ECR can only be performed in large centres with neuro-interventional capabilities. In Western Australia, there are two interventional neurology services, one operating 24 hours, and another during business hours only. Both centres are in Perth, in the South West of a state covering 2.5 Million square kilometres.
The Royal Flying Doctor Service, Western Operations (RFDS WO), transfers over 300 patients per year with an acute stroke diagnosis. Since 2016, we have received increasing numbers of urgent transfer requests for patients with acute stroke, who have been deemed candidates for ECR, many of whom are several hundred kilometres away from Perth.
RFDS WO have developed guidelines and polices in tandem with the WA Stroke Service and state Emergency Telehealth Service, to improve aeromedical retrieval services and provide the best possible care and outcomes for patients with acute stroke in country Western Australia.
This presentation will review the Western Australian acute stroke retrieval experience, including the demographics, challenges and outcomes of long distance retrieval for ECR.