Letter to the editors: the potential role for prehospital thrombolysis and time-critical stroke transfers in the northern Norway aeromedical retrieval system; In response to: Norum J, Elsbak TM: Air ambulance services in the Arctic: a Norwegian study. Int J Emerg Med 2011, 4:1.

The role for prehospital thrombolysis for ST-elevation acute myocardial infarction and time-critical stroke transfers in the northern Norway aeromedical retrieval system as well as the aero-evacuation impact of increased Arctic expedition tourism could benefit from further discussion by Norum and Elsbak. Close ECG surveillance for ST elevation and retrieval thrombolysis en route to the accepting hospital could be of benefit for acute coronary syndrome patients in northern Norway who require prolonged aeromedical transfer. For patients who remain within a reasonable time frame for stroke thrombolysis (up to 4.5 h after symptom onset), expedited transfer for neuroimaging to determine eligibility is recommended.