Mobile Stroke Units

Mobile stroke units are a new way for stroke patients to get faster emergency stroke treatment.

Mobile stroke units were first introduced in Germany and found to be successful in treating stroke patients within the first hour of initial stroke symptoms. The first mobile stroke unit in the United States was launched in Houston, Texas at the University of Texas Health Science Center in May 2014 and another mobile stroke unit system was established on the city of Cleveland by the Cleveland Clinic in 2015.

So far, results have been promising. 

What is a mobile stroke unit?

A mobile stroke unit is an ambulance equipped with a mobile CT scanner to obtain on-the-spot brain imaging for patients who might have a stroke, instead of waiting to obtain a Brain CT scan when patients arrive to the hospital. A mobile stroke unit also has laboratory equipment, telemedicine capabilities and high-speed wireless transmission of data so that doctors can quickly determine whether the patient is a candidate for emergency stroke treatment. Mobile stroke units may also be prepared to administer Tissue Plasminogen Activator (tPA) on board.

What are the benefits of a mobile stroke unit?

The most effective stroke treatment, tPA, is a powerful blood thinner that must be given to patients shortly after the initial symptoms of a stroke begin. In recent years, emergency departments in hospitals across the country have implemented ways to recognize and evaluate stroke patients for safe and effective treatment with better overall patient outcomes than in the past.

However, the time window for treatment with tPA is very short, because if a patient gets tPA after the short time period has elapsed, it would cause more harm than good due to bleeding complications.

That means that most patients do not get appropriate stroke treatment because it usually takes too long for stroke patients to get to the hospital.

And, there is evidence that even within the short window of allowed time for tPA, the sooner stroke patients get it, the less severe the overall effects of the stroke. So with mobile stroke units, valuable time is saved by getting the best medical treatment possible to stroke patients on the way to the hospital or as soon as they arrive to the hospital. This increases patient survival and improves outcome for stroke survivors.  

The University of Texas Health Science Center did a study on the outcomes of their mobile stroke unit, The Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit (BEST-MSU) study. Results showed that patients were able to receive appropriate treatment within 60 minutes of their initial stroke symptoms and there were no reports of bleeding complications of stroke treatment.

What does it mean for you if your city has a mobile stroke unit?

The Cleveland Clinic, in cooperation with Cleveland emergency medical systems (EMS) recently instituted a plan for a mobile stroke unit for residents of the city of Cleveland.

Based on the arrangement, patients who need mobile stroke unit care are given the same treatment regardless of their ability to pay. Patients have the neurological evaluation and Brain CT scan on route to the nearest hospital equipped to treat emergency stroke patients, while the plan for treatment is started prior to the patient's arrival. This means that if you live in a city with a mobile stroke unit, you are more likely to have a faster stroke evaluation and a speedier treatment time. The whole idea of a mobile stroke unit is a very new one, and practical ways to evaluate the real life patient benefits and to make it more widely available will most likely be one of the new directions of stroke care over the coming years.

Sources:

Benefits of Stroke Treatment Using a Mobile Stroke Unit Compared With Standard Management: The BEST-MSU Study Run-In Phase, Bowry R, Parker S, Rajan SS, Yamal JM, Wu TC, Richardson L, Noser E, Persse D, Jackson K, Grotta JC, Stroke, December 2015

Stroke management and the impact of mobile stroke treatment units, Rasmussen PA, Cleveland Clinic Journal of Medicine, December 2015

Establishing the first mobile stroke unit in the United States, Parker SA, Bowry R, Wu TC, Noser EA, Jackson K, Richardson L, Persse D, Grotta JC, Stroke, May 2015

Continue Reading