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Mobile stroke units could expedite treatment and improve patient outcomes in urban areas

Press releases may be edited for formatting or style | December 05, 2019 Cardiology Stroke
DALLAS, Dec. 4, 2019 — Mobile Stroke Units (MSUs), vehicles equipped to provide stroke treatment before reaching a hospital, provided lifesaving care to stroke patients in Manhattan approximately 30 minutes faster, compared to patients transported to hospitals in traditional ambulances and who did not receive stroke treatment until arriving at the hospital, according to new research published in the Journal of the American Heart Association, the open access journal of the American Heart Association.

“This study provides further evidence suggesting a potential role for mobile stroke units in dense urban areas to increase our ability to treat stroke patients faster,” said Lee H. Schwamm, M.D., executive vice chairman of neurology and director of the MGH Comprehensive Stroke Center at Massachusetts General Hospital in Boston. “This study joins a large body of efforts to improve how we swiftly recognize, triage, transport and treat patients with stroke, which is the ultimate goal.”

Ischemic stroke – the most common type of stroke – occurs when a vessel supplying blood to the brain becomes blocked by a blood clot and prevents regular blood flow. Ischemic strokes are often treated with the medication alteplase, which breaks up clots. However, patients must be accurately diagnosed, and treatment with alteplase should be administered within 3 to 4.5 hours from when symptoms begin. MSUs offer the possibility of diagnosis and treatment for stroke in a specialized ambulance before patients arrive at the hospital.

In this study, the patients treated for ischemic stroke in the MSU received alteplase approximately 30 minutes sooner than patients who received treatment at the hospital.

“When it comes to stroke treatment, 30 minutes can be the difference between making a full recovery from a stroke and living independently, or becoming disabled and needing help with the activities of daily living,” said the study’s lead author, Matthew E. Fink, M.D., chair of neurology and the Louis and Gertrude Feil Professor in Clinical Neurology at Weill Cornell Medicine in New York, and neurologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center. “The faster patients receive alteplase, the more likely they are to recover quickly and with fewer complications.”

The study utilized NewYork-Presbyterian Hospital’s Mobile Stroke Units (MSUs), and they were equipped with a portable CT scanner that allows neurologists on board to evaluate if a patient is having an ischemic stroke. If a stroke is diagnosed, the emergency medical technicians in the MSU can immediately administer alteplase. The New York City MSU program was launched in October 2016 by NewYork-Presbyterian, Weill Cornell Medicine, Columbia University Irving Medical Center and the Fire Department of the City of New York with one unit in Manhattan. One MSU was operated and responded to EMS calls from 9 a.m. to 5 p.m. on weekdays during the study.

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