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Mobile Stroke Care Units Improve Treatment

Mobile stroke treatment units can cut time to therapy in half.
 
Published Online: Oct 31,2016
Laurie Toich, Assistant Editor
“When someone has a bad stroke that is a large vessel occlusion (blockage) that doesn’t respond to tPA, it’s crucial that the patient be taken immediately to a comprehensive stroke center like Rush,” Dr Lopes said.

For these patients, a thrombectomy to remove the blockage in the brain is crucial. Only comprehensive stroke centers are staffed with neuroendovascular surgeons able to perform these procedures. In the Chicago area, there are only 6 centers, including Rush University Medical Center, that offer the procedure.

By diagnosing the patient immediately, the first responders are able to transport the patient to an appropriate facility.

“If you’re not assessing patients in the field, you’re missing an opportunity. If patients who need thrombectomy aren’t taken directly to a comprehensive center, it will cause significant delays in their receiving the care they need,” Dr Lopes said. “The CT in the Mobile Stroke Unit will allow us not only to obtain brain but also blood vessel pictures. This information is essential to determine the level of care the patient needs.”

Patients who experience a hemorrhagic stroke can also benefit from the mobile unit. These patients, whose blood vessels leak or burst, cannot receive tPA since it could be fatal.

“With the CT scan, the mobile stroke team can separate the bleeding strokes in the brain from the blockage strokes,” Dr Lopes said. “If it’s a bleeding stroke, we can initiate measures in the field to control blood pressure, optimize patient coagulation and alert the surgical team in the hospital to get ready. It can be life-saving if you’re able to get to the hospital and get the patient right into surgery and alleviate the pressure on the brain.”

The goal of this new program is to capture 75% of strokes in time to deliver beneficial treatments for the patients, according to the press release. Rush University Medical Center will also be conducting an educational outreach program that focuses on recognizing and responding to stroke symptoms.

"We've been trying to cut down the 'door to needle times' — the time it takes a patient to be treated in the emergency room – as much as possible,” Dr Conners said.

Other mobile units have been found to reduce the time between the onset of the stroke to treatment by 50%, with most treated within 30 minutes. Participants in Rush University’s Mobile Stroke Unit hope to see similar successes.