Abstract Number: Esoc2026ys70 Point-of-Care Gfap Testing in Helicopter Emergency Medicine to Support Early Triage of Suspected Intracranial Hemorrhage

Abstract Background and aims Rapid identification of intracranial hemorrhage (ICH) in the prehospital setting remains challenging, particularly during helicopter emergency medical service (HEMS) missions where target hospitals are selected based on presumed diagnoses. Glial fibrillary acidic protein (GFAP) has emerged as a promising biomarker for early detection of ICH. We evaluated the utility of prehospital GFAP testing to support triage of patients with suspected ICH during HEMS missions. Methods This ongoing prospective study involves two HEMS bases in Germany. Patients with a reduced level of consciousness (GCS9) with or without traumatic brain injury (TBI) were included. GFAP point-of-care measurements were performed in the prehospital phase using the i-STAT Alinity analyzer (Abbott) and a portable centrifuge. Results To date, 28 patients have been enrolled (mean age 62.3 years; 32% female). Median (IQR) GCS was 3 (3-4) and 43% of patients suffered from TBI. GFAP plasma concentrations were markedly higher in patients with ICH (n=17) compared with those with other causes of sopor or coma (median 3052 pg/mL IQR 849–10 001 vs. 57 pg/mL IQR 46–75.5; p0.001), allowing for a high positive predictive value. GFAP results were available before first imaging in 18%. Conclusion Prehospital GFAP testing during HEMS missions allows rapid ICH detection and may support early triage decisions in the future. However, the requirement for plasma centrifugation represented a relevant logistical limitation. From December 2025 further research will focus on the use of whole-blood GFAP cartridges to simplify prehospital testing and targeted hospital selection for patients with suspected ICH. Conflict of interest Sabina Zylyftari nothing to disclose