East Anglian Air Ambulance trial shows promise for rapid brain bleed detection

East Anglian Air Ambulance (EAAA) has reported promising results from a pre-hospital blood testing program designed to help critical care teams identify patients with suspected intracranial hemorrhage before they reach hospital.

The UK air ambulance charity said its BRAIN-FIRST study correctly identified all cases of intracranial hemorrhage among an initial cohort of 65 patients with acute non-traumatic coma, tested between January 2025 and April 2026.

The program uses Abbott’s handheld i-STAT Alinity analyzer to measure two biomarkers associated with brain injury, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1). Results are available within minutes, providing doctors and paramedics with additional information during their initial assessment.

Identifying patients at high risk of intracranial bleeding before hospital arrival could help helicopter emergency medical services (HEMS) teams make more informed triage and destination decisions, potentially reducing secondary transfers from hospitals without specialist neurosurgical facilities.

Dr James Price, HEMS Consultant and Clinical Lead for Research and Development at EAAA, said the findings demonstrated the potential of bringing laboratory-style testing into pre-hospital critical care.

“For the first time, we can obtain biological information about possible brain injury while we are still at the patient’s side,” he commented.

“Earlier identification of patients at high risk of a serious bleed on the brain has the potential to reduce delays to specialist treatment, avoid unnecessary secondary transfers between hospitals, and help ensure patients reach the right care, in the right place, as quickly as possible.”

The initial findings are encouraging, although the relatively small study population means further evaluation is needed before the approach can be more widely adopted. The blood test provides supplementary clinical information rather than replacing hospital-based CT imaging.

EAAA said its critical care teams have now used the technology with more than 200 patients with suspected serious brain injury.

The charity is working with UK and international ambulance services to expand the research into larger patient populations. A follow-up project, BRAIN-FIRST2, will investigate how biomarker results can be combined with clinical assessments to support more individualized pre-hospital treatment and transport decisions.

Further reading: Essex & Herts Air Ambulance has also introduced new technology to improve pre-hospital assessment of patients with head injuries, using pupillometers to help clinicians detect neurological changes.