Paramedic PapersHome Stroke & neuro POC GFAP for brain haemorrhage in coma
Stroke & neuro
POC GFAP for brain haemorrhage in coma
Prehospital Point-of-Care GFAP for Detection of Intracranial Hemorrhage in Acute Nontraumatic Coma
JAMA Network Open · 2026-10-01 · Added 17 October 2026
A UK physician-paramedic HEMS team tested whether prehospital point-of-care GFAP and UCH-L1 blood tests could detect intracranial haemorrhage in comatose patients — GFAP performed strongly (97% sensitivity, AUC 0.94), UCH-L1 less so.
- Study type
- Cohort
- Design
- Diagnostic accuracy study (prehospital point-of-care biomarkers vs CT)
- Participants
- 65 adults with acute nontraumatic coma (GCS ≤12)
- Main finding
- POC GFAP detected ICH with 97.0% sensitivity (95% CI 84.2–99.9%) and AUC 0.94; ICH was present in 51% of patients and 30-day survival was 46%.
- Caveat
- Small, highly selected cohort — physician-staffed HEMS patients with suspected ICH already undergoing prehospital RSI.
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Point-of-care brain biomarker testing isn't something Australian ambulances carry, and the cohort came from a physician-staffed helicopter service already inducing patients — adoption here would need a guideline change and a very different crew model.
Learning goal
Weigh the value of point-of-care biomarkers like GFAP when assessing comatose patients with suspected intracranial haemorrhage.
More
- Topic: Stroke & neuro
- Daily scan: 17 October 2026
- Podcast: Paramedic Papers Daily, 17 October 2026
Related papers on Stroke & neuro
-
Scene-to-door time and stroke thrombectomy
A single-centre Japanese cohort of 121 stroke thrombectomy patients transported directly from scene found scene-to-door time was only associated with outcome in patients with pre-stroke disability, where longer intervals were linked to lower odds of a favourable 90-day outcome (aOR 0.91; ROC cut-off 14 minutes in that subgroup).
-
Decision support eases stroke triage load
In a randomised crossover simulation trial, 35 Taiwanese emergency medical technicians using a stroke triage decision-support interface showed reduced mental workload (RMSSD up 4.3 ms, heart rate down, NASA-TLX lower) versus dispatch orders alone.
-
Mobile stroke units: value depends on setup
Narrative review concludes mobile stroke units deliver thrombectomy-relevant time savings only when onboard CTA links to direct routing and receiving-centre activation — non-contrast-CT units mainly speed prenotification.
-
Stroke app speeds prehospital-to-ED handover
A South Korean pilot of a mobile app that streams stroke data from ambulances to EDs found shorter onset-to-door times in 34 app-supported transports versus 129 matched standard transports.