What’s new in health care: Mobile Stroke Unit
Nurse Mila is assigned at the Intensive Care Unit today and is currently assessing a stroke patient. After thorough assessment, she then proceeds to the station and records her findings all while thinking about how it would be like treating stroke patients who live very far from the hospital or any medical facility. What if, due to the distance and inaccessibility of care, complications may arise and they may not make it? She shakes her head, wishing for a time when health care would be accessible to everyone even to those who live in remote areas.
Mobile Stroke Unit? What is?
Stroke is considered a medical emergency. In this condition, every second counts as time is critical for saving the brain, and patients’ lives. In the case of most strokes, it is important to note that the earlier thrombolytic treatment is given the better the outcome. But how would this be possible for patients living in places not so close to the hospital? This is where the mobile stroke unit comes in.
The mobile stroke unit is a specialized ambulance which has a portable CT scanner and laboratory equipment on it which are essential for the diagnosis of stroke. Via telemedicine, CT images and videos of the patient examination can be then sent to the hospital where specialists can help in diagnosis and treatment management.
The goal of the Mobile Stroke Unit is to shorten the time between the onset of stroke-like symptoms and the delivery of thrombolytic drugs, which must be administered within three hours of when symptoms began or when the patient was last known to be well.
Looks can be deceiving
While the unit may look like an ambulance on the outside, inside it you will find a highly specialized staff, equipment and medications which are strictly used for diagnosing and treating strokes. The CT scanner which is capable of imaging the patient’s brain to identify the type of stroke they are experiencing transmit information wirelessly to neuroradiologists, who interpret if the patient is experiencing a stroke, and if so, whether the stroke is ischemic or hemorrhagic. Via telemedicine technology, stroke neurologists access the patient’s symptoms while the unit is on the way to the hospital.
Included in the unit is also a mobile lab which tests blood samples on board. If it is found that the patient is undergoing an ischemic stroke, then the on-board medical team, in attempt to break up the clot, can start giving intravenous (IV) tissue plasminogen activator (tPA).
Advantages of the mobile stroke unit
Stroke happens when blood flow to the brain is interrupted by a blockage or a rupture in an artery, depriving brain tissue of oxygen. It is reported to be the fourth leading cause of death in the United States and a leading cause of disability. According to the American Stroke Association and the Centers for Disease Control, nearly 800,000 Americans suffer a stroke each year (one every 40 seconds).
In one study conducted wherein the researchers had planned to include 200 patients but stopped the trial after analyzing results on the first 100 (53 in the pre-hospital stroke treatment group, 47 in the control group), it has been found out that compared with standard hospital treatment, the pre-hospital stroke treatment:
- reduced the time from the first call for help to a decision about treatment, from 76 to 35 minutes on average (median difference 41 minutes, 95% CI 36 to 48 minutes);
- reduced the average time between the first call for help and the end of CT scan;
- reduced the average time between the first call for help and the end of laboratory analysis; and
- reduced the average time between the first call for help and the start of intravenous thrombolysis for eligible ischemic stroke patients
Sources:
- http://my.clevelandclinic.org/services/neurological_institute/cerebrovascular-center/treatment-services/mobile-stroke-unit
- http://www.nhs.uk/news/2012/04april/Pages/fast-mobile-stroke-treatment-tested.aspx
- https://www.uth.edu/media/story.htm?id=b1485cfc-110f-4a4c-91ea-06b573b3ba6d
Liane Clores, RN MAN
Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.
