Abstract 13: The Feasibility and Development of a Mobile Stroke Unit in a Community Setting

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Introduction: Time is brain, the faster a stroke patient is treated the better the outcome. Mobile Stroke Units (MSU) are an innovation in care allowing a specialized team to treat the patient in a pre-hospital setting. As hospitals consider the addition of a MSU, the feasibility of the program must be carefully explored, along with the challenges that come with developing a program. This abstract aims to discuss one hospital’s journey to develop and implement a MSU to bring cutting edge care to the community.Hypothesis: A hospital can operate in partnership with local EMS to provide stroke care to patients in the pre-hospital setting.Methods: A community hospital conducted a feasibility study to determine the effects of a MSU within their local EMS region. This study involved reviewing market share and trends, as well as, financial metrics. Following the feasibility study, an investment was made to develop a MSU program. Program development consisted of 5 main teams: Compliance/Regulatory, EMS, Communications/Marketing, Operations, and Vehicle Acquisition. Focus was also placed on staffing the MSU with a critical care nurse, critical care paramedic, CT technologist, and a paramedic driver. This team received specialized training, along with local EMS, to care for the stroke patient in the pre-hospital setting. The MSU is equipped with a CT scan and IV alteplase or prothrombin complex concentrate. Additionally, the use of telemedicine is used to include the neurologist and radiologist in the care of the pre-hospital stroke patient.Results: The Mobile Stroke Program was successfully launched by this community hospital within 8 months of project kickoff to Go-Live. In the first 6 months of operations, the MSU has been dispatched 182 times and has transported 102 patients from all 6 towns within the EMS region. Endorsement of the MSU services to the community was received from all six Fire Chiefs within the EMS system.Conclusions: A community hospital in partnership with local EMS and Department of Regulation can be successful in determining the need, scope, and program criteria for a MSU. This approach can support an expedited timeline while assuring the highest standard of stroke care.>

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