B-PROUD Shows that Mobile Stroke Units (MSUs) Improve Clinical Outcomes
When the pioneering MSU group from Berlin reported results of their B-PROUD trial, they presented the best evidence to date that MSUs do more than accelerate care delivery for acute ischemic stroke but actually improve patients’ functional outcomes as well. This investigation is the first reported randomized trial showing improved outcomes for patients treated on an MSU compared with those receiving conventional care from EMS and emergency departments.
Mobile Stroke Units in Berlin Led to Faster Care, Better Outcomes
LOS ANGELES, CA—Deploying mobile stroke units on the streets of Berlin, Germany, not only got thrombolytic therapy to patients with acute cerebral ischemia faster, but also improved functional outcomes 3 months after the event, results of the B_PROUD trial show. Patients treated when a specialized unit—called a STEMO—was available were more likely to receive thrombolytic therapy (60% vs 48%) and had a shorter time to treatment (50 vs 70 min; P < 0.01 for both), Heinrich Audebert, MD (Center for Stroke Research Berlin), reported at the International Stroke Conference here.
Mobile Stroke Units: Are they worth the cost?
They’re a hot idea and spreading rapidly: Since the U.S.’ first mobile stroke ambulance hit the streets in Houston in 2014, at least a dozen have followed in other cities, with more planned.1 There’s just one catch: There’s no data that shows they actually improve patient outcomes. And given their cost, that’s leading an increasing number of docs and other emergency leaders to question whether they really represent the best use of limited dollars.
Mobile Stroke Unit Reduces Time to Treatment
Stroke is the fifth leading cause of death in the United States, responsible for more than 140,000 deaths in some of the most recent data.1 When treating stroke patients, perhaps more than any other condition, time is of the essence. ‘We know that for every 15 minutes you delay treatment, you lose three and a half years of your life,’ said Harish Shownkeen, M.D., interventional neuroradiologist at Northwestern Medicine Central DuPage Hospital (CDH) in Winfield, Ill. In an effort to reduce time to treatment and improve patient outcomes, in 2017 Shownkeen and CDH, a Joint Commission-accredited Comprehensive Stroke Center, turned to an innovative solution that has slowly been making its way across the U.S. — a mobile stroke unit.
First EDition: Mobile Stroke Units Becoming More Common
Specially equipped ambulances that bring a diagnostic computed tomography (CT) scanner and therapeutic thrombolysis directly to patients in the field—have begun to proliferate across the United States, although they remain investigational, with no clear proof of their incremental clinical value or cost-effectiveness. The first US mobile stroke unit (MSU) launched in Houston, Texas in early 2014 (following the world’s first in Berlin, Germany, which began running in early 2011), and by early 2017, at least eight other US MSUs were in operation, most of them put into service during the prior 15 months.
Mobile Stroke Units Might be the Answer to Quicker Treatment
Vehicles equipped to provide stroke treatment before reaching a hospital – can give lifesaving care to stroke patients about 30 minutes faster than standard hospital treatment, according to a new study. Researchers analyzed 66 patients with symptoms of stroke who were taken to the hospital by a mobile stroke unit, compared to 19 suspected stroke patients taken by a traditional ambulance in the Manhattan borough of New York City from October 2016 to September 2017. Neurologists in the mobile stroke unit diagnosed stroke in 29 of the patients and treated them immediately. Nine of the 19 patients transported by a traditional ambulance were diagnosed with stroke and received treatment at the hospital. On average, the patients treated in the mobile stroke unit received care half an hour faster.
Mobile Stroke Units get Patients to Hospital Faster than Ambulances
Transport to the hospital via mobile stroke unit—as opposed to standard transit in an ambulance—saved stroke victims 10 minutes and up to 270 million neurons in a study out of the University of Texas Health Science Center at Houston. Five years ago, McGovern Medical School at UTHealth was the first center in the U.S. to launch a mobile stroke unit—an ambulance that’s specially equipped to diagnose and treat stroke while patients are en route to their local hospital. On board, an interdisciplinary medical team performs diagnostic imaging and neurological exams to determine whether patients are good candidates for endovascular thrombectomy. If they determine the patient should undergo thrombectomy, mobile stroke unit teams are able to notify the nearest hospital that they’re on their way, giving on-site physicians a chance to organize and prepare for the procedure before the victim even makes it to the endovascular suite.
Mobile Stroke Units: The next frontier in stroke treatment
Mobile stroke units (MSUs) are all the rage now in the stroke world, and for good reason. Stroke treatment has always been time-sensitive, with acute treatment being limited by the ability of physicians to assess stroke patients until they arrive in the emergency room. Now these MSUs—ambulances equipped with a portable CT scanner, point-of-care laboratory testing, access to a vascular neurologist, and select medications—allow for acute stroke workup and treatment to start even before the patient gets to the hospital.
Mobile Stroke Units Hasten Triage Even in Dense Cities
Dedicated ambulances that enable rapid stroke diagnosis and treatment while en route to the hospital deliver substantial time savings even in densely populated areas, data from a New York-based registry show. Mobile stroke units (MSUs) are equipped with a CT scanner, intravenous tissue plasminogen activator (tPA), point-of-care blood testing, antihypertensive drugs, and antiepileptic drugs plus the usual equipment found in paramedic ambulances. In rural areas, they offer known benefits, but whether these advantages would be diluted by traffic and other big-city obstacles was uncertain, lead author Matthew Fink, MD (Weill Cornell Medicine, New York, NY), told TCTMD.
UT Mobile Stroke Unit Saves Man Stricken during Flight
Gerald Sandlin practically hopped out of bed, which is saying something for a man who two days earlier suffered a near-fatal stroke some 30,000 feet up in the air. ‘I feel good. I feel in control again,’ said Sandlin, 73, as he walked the halls of Methodist University Hospital on Thursday afternoon. Culminating a recovery that's been nothing short of dramatic, the retired store manager should be released from the hospital Friday. He and his wife Barbara then will be able to make it back to their home in Vinemont, Alabama. How they even wound up in Memphis is a tale of luck — both bad and good — and an expensive new medical asset located here.
Mobile Stroke Treatment Unit brings Care to You
DENVER—When someone has a stroke, time is of the essence. Now a specialized ambulance can respond with everything needed to diagnose, and treat a stroke on site, right in your driveway. Just a few cities across the country have these units. UCHealth has one Mobile Stroke Treatment Unit that splits time between the hospital in Aurora and one in Colorado Springs. It has CT scanner to check the brain, clot busing drugs, and a communication system that allows doctors to virtually see the patient. Plus there are four crew members including a CT technologist and a nurse who specializes in stroke.
State-Of-The-Art Ambulance Provides Life-Saving Help For Stroke Victims
NEW YORK (CBSNewYork) — Ever see an ambulance stuck in traffic and say to yourself, “I hope they get to the person in time? Seconds count in all emergency cases, but time is especially critical if the victim is having a stroke. As CBS2’s Dr. Max Gomez reports, New York has a special ambulance to save those lives. It’s called a mobile stroke treatment unit, and it’s a million dollar ambulance that brings everything needed to diagnose a stroke and start clot busting drugs as quickly as possible.
Creating and Operating a Mobile Stroke Unit (VIDEO)
TN Associate Editor Jeff Zagoudis explores how the Mobile Stroke Unit (MSU) program at Northwestern Medicine Central DuPage Hospital in Winfield, IL, is changing the paradigm of care for stroke patients in the western suburbs of Chicago and beyond.
Northwestern Medicine Mobile Stroke Unit Delivers Life-Saving Care 30 Minutes Sooner
A new data analysis of the Northwestern Medicine Mobile Stroke Unit (MSU) found the specialized ambulance provided life-saving treatment 30 minutes faster than traditional transport in its first year of operation. The analysis found, on average, the MSU delivered the clot-busting drug tPA to ischemic stroke patients 52 minutes after 9-1-1 dispatch, compared to an average of 82 minutes for patients transported via ambulance.
Mobile Stroke Unit 'Proves a Success'
Stroke victims who receive emergency treatment from the Siriraj Mobile Stroke Unit -- the country's first mobile telemedicine unit -- face a lower risk of paralysis or death, according to the director of Siriraj Stroke Centre. Dr. Yongchai Nilanont said on Tuesday that patients treated in the mobile unit have a 60% chance of recovering, while those who received initial treatment in hospital have a 40% chance of recovering.
Mobile Stroke Units: Weighing the conflicting arguments
In just five years the United States has expanded from its first mobile stroke ambulance in 20141 to roughly a dozen mobile stroke units (MSUs) now spanning from California to New York City. Whether MSUs are an effective and efficient means of prehospital care, however, continues to generate a great deal of debate. Through analysis of current evidence, it is clear MSUs give first responders a tool that can lessen the time to administer interventions to stroke patients. Skepticism persists, though, over the notable cost, potentially minimal benefit, and overall allocation of resources.
Mobile Stroke Units Drive Better Functional Outcome
LOS ANGELES―The availability of mobile stroke units (MSUs), specially equipped ambulances that enable patients who are experiencing an acute stroke to be scanned and treated before they arrive at the hospital, was associated with better functional recovery in a new prospective study. Disability and death rates were 26% lower in an adjusted comparison between people who received treatment in the prehospital setting vs those who received standard treatment upon arrival at an emergency department in Berlin.
UCLA Mobile Stroke Unit Expands to South Bay Cities, Bringing Chance to Save Lives
When it comes to recovering from a stroke, every minute matters. It’s something Los Angeles County Supervisor Janice Hahn knows all too well. Her father, Kenneth Hahn – who held a supervisor seat for 40 years before she did – suffered from the effects of a stroke for the last 10 years of his life, she said, including paralysis on one side of his body. Hahn’s father was also involved in the movement to create paramedics 50 years ago. So for Hahn, Wednesday, Sept. 18, felt like a full-circle moment, as she joined local and county officials at Torrance City Hall to announce the expansion of the UCLA Mobile Stroke Unit to South Bay cities.
When Time Is a Matter of Life or Death
When someone has a stroke, a race against the clock begins. The average patient loses 1.9 million brain cells each minute that an ischemic stroke, in which a clot blocks blood flow in the brain, goes untreated. The first challenge is to get people to recognize the signs of stroke and act quickly. The next is to transport them to the right medical center fast enough. Not all hospitals are equipped to handle stroke, so many patients don't get the treatment that can save their lives and prevent disability. But some medical centers are taking a new route to better results: They're bringing the emergency room to the patient.
Mobile Stroke Unit Treatment Reduces Stroke Disability Compared with Standard Care
LOS ANGELES—Specialized mobile stroke unit ambulances outfitted with CT machines appear to make a difference in how well patients recover from stroke, researchers reported here at the American Heart Association/American Stroke Association International Stroke Conference 2020. Heinrich Audebert, MD, professor of neurology at the Center for Stroke Research at Charité-Universitätsmedizin in Berlin and the senior author of the Berlin Prehospital Or Usual Delivery trial, reported that 63 percent of patients treated in the mobile stroke unit were discharged with a modified Rankin Scale score of 0–2 compared with 57 percent of the patients who were treated with usual care, but not in a stroke unit vehicle. That translated to a 26 percent reduction in disability among those patients, which was statistically significant (p=0.003).
Stroke Transport: Faster! Faster! Faster! — Mobile stroke units quicken surgical treatment by 10 minutes
For stroke patients who undergo intra-arterial thrombectomy (IAT), mobile stroke units generated faster surgical treatment times compared to ordinary emergency medical service transport, recent research shows. Time is brain" has been a maxim in stroke care for more than a decade. Research published earlier this year indicates brain cell loss during acute ischemic stroke (AIS) ranges from 35,000 cells per minute to more than 27 million cells per minute in "fast progressor" patients. Intravenous administration of tissue-type plasminogen activator (tPA) and IAT are two of the primary standard-of-care interventions for stroke. IAT is performed mainly at tertiary care hospitals. In the study published in Stroke, mobile stroke units (MSUs) were associated with a 10-minute gain in a key IAT workflow metric: emergency room arrival to treatment time, or door-to-puncture-time (DTPT). The median DTPT time for MSU patients was 89 minutes compared to 99 minutes for emergency medical services patients.
Mobile Stroke Unit Aims to Bring Hospital to Patient (Video)
Gallery furniture owner Jim "Mattress Mack" McIngvale is contributing to an innovative new mobile stroke unit, the first of its kind in the US. Dr. James Grotta and a small team of physicians and medical technicians have begun using an ambulance equipped with a computed tomography, or CT, scanner. The scanner is built into the back of the ambulance, giving Grotta and the EMTs the capability to test and treat the patient for a stroke on the spot, rather than waiting to treat the patient until they get back to the hospital. If successful, this could save patients from irreparable damage suffered by a stroke.
Cleveland Clinic to Launch Mobile Stroke Unit, Bringing the ER to Stroke Patients in Cleveland
CLEVELAND, Ohio—During a stroke, every passing minute without treatment drastically reduces the odds a patient will fully recover. Starting this summer, the Cleveland Clinic will try a bold new approach to cutting down on the time it takes to diagnose stroke and start life-saving clot-busting drugs: The health system will deploy a high-tech $1 million ambulance-like mobile stroke unit that will bring the brain imaging, lab and specialists to the patient.
