Background Eighty five percent of strokes are due to an ischaemic event and approximately 10% of these can now be treated with mechanical thrombectomy retrieval (MTR). The benefit of MTR drops by 5.7% for every hour since onset. In Devon, MTR is currently only available at University Hospital Plymouth (UHP). The longest transfer time to UHP is undertaken by patients at North Devon District Hospital (NDDH); approximately 110 minutes by road. A quality improvement project was designed to reduce the transfer time for these patients and increase the number of patients eligible for MTR.

Methods A collaborative team of Devon Air Ambulance (DAATCL), NDDH and UHP designed a transfer protocol for MTR eligible patients to be airlifted to UHP, reducing the transport time of 110 minutes by land to approximately 20 minutes by air. DAATCL liaised with South Western Ambulance Service (SWASFT) HEMS dispatchers to provide a specific dispatch procedure for MTR transfers.

Results The pilot has now been running for 12 months and 16 patients have been transferred for MTR at UHP. The median transfer time was 25 minutes by air, giving a median time saving of 1 hour 25 minutes compared to a land transfer.

Conclusion Sixteen patients have benefited from this new service, and it is anticipated that numbers will increase as the MTR service expands. MTR is not yet a 24/7 service, however it is hoped this will be achieved within the next few years. MTR is an expensive procedure, however due to reduced hospital stay and social care needs, cost savings can be considerable; and the benefit to patients and their families can be even greater. There is also wider benefit to patients in the region with land resources available to respond to other 999 calls when they would have been otherwise unavailable during the transfer.