{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:23:30Z","timestamp":1787657010945,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013232","name":"Stiftelsen Norsk Luftambulanse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013232","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Transcranial color\u2010coded Doppler (TCCD) is a noninvasive, widely available diagnostic method that may identify large vessel occlusion (LVO) in acute stroke patients. This study aimed to explore whether helicopter emergency medical services (HEMS) physicians could use TCCD in a prehospital setting to identify the proximal segment of the middle cerebral artery (M1\u2010MCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a feasibility study following brief training, three HEMS physicians and a single\u2010reference examiner performed transtemporal TCCD examinations of four healthy volunteers, on ground and in flight a cruising helicopter. One color and one pulsed\u2010wave Doppler image of M1\u2010MCA were stored per examination, and time was recorded. TCCD images were retrospectively assessed by two raters for M1\u2010MCA identification success and image quality, using a 5\u2010point Likert scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants performed a total of 32 bilateral M1\u2010MCA examinations. The HEMS physicians identified M1\u2010MCA in 83% of color Doppler examinations, with median (interquartile range [IQR]) time of 83 (63\u2013130)\u00a0s. Substantial inter\u2010examiner variability was observed. The single\u2010reference examiner identified M1\u2010MCA in 88% of color Doppler examinations using 58 (49\u2013101)\u00a0s. Median (IQR) Likert scores for successful images were high: HEMS physicians 4.5 (4.5\u20135.0) and single\u2010reference examiner 5.0 (4.5\u20135.0), with no significant difference between on\u2010ground and in\u2010flight examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Following brief training, HEMS physicians were able to perform TCCD field examinations of M1\u2010MCA in healthy volunteers, with identification rates and image quality comparable to a single\u2010reference examiner. Substantial inter\u2010examiner variability was observed, highlighting the importance of tailored training and competency assessment. Research is required to evaluate TCCD use by HEMS physicians under real\u2010world prehospital conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70145","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:37:48Z","timestamp":1787056668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transcranial Ultrasound in the Helicopter Emergency Medical Services\u2014A Feasibility Study"],"prefix":"10.1111","volume":"36","author":[{"given":"Ingrid N.","family":"Rognes","sequence":"first","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Department of Anesthesiology and Intensive Care Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e5l C. W.","family":"Morberg","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Department of Anesthesiology Vestfold Hospital Trust  T\u00f8nsberg Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette S.","family":"J\u00e6ger","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Center for Laboratory Medicine \u00d8stfold Hospital Trust  Gr\u00e5lum Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"Rehn","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Prehospital Division Air Ambulance Department Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"St\u00f8","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Alteheld","sequence":"additional","affiliation":[{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else Charlotte","family":"Sandset","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren R.","family":"Hov","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"},{"name":"Department of Prehospital Medicine Oslo Metropolitan University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karianne","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Norwegian Air Ambulance Foundation  Oslo Norway"},{"name":"Institute of Clinical Medicine Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023336"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003981"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445\u20105994.2010.02280.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.029318"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.4045\/tidsskr.24.0020"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/2396987321989865"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873221079413"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"issue":"13","key":"e_1_2_9_10_1","first-page":"e771","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"151","author":"Rao S. 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