Introduction: Recent evidence suggests that Mobile Stroke Units have demonstrated improved time to treatment in urban settings. These vehicles are equipped to respond to out of hospital strokes and begin treatment with the use of IV alteplase. The evidence is limited to urban settings and the full impact of mobile stroke units on stroke treatment times and outcomes should be studied in urban, suburban and rural communities. This abstract aims to describe the impact of a mobile stroke unit in a suburban community.
Hypothesis: A mobile stroke unit in a suburban setting can improve time to treatment for stroke patients for ischemic stroke patients.
Methods: The mobile stroke unit responds to a 6 town area within the hospital’s EMS (Emergency Medical Services) system, data from mobile stroke unit patients was compared to data from stroke patients brought to the Emergency department by conventional EMS from January-June 2017. The mobile stroke unit is dispatched for patients deemed as potential strokes by the centralized 911 dispatch. The patient is then evaluated by a specially trained crew consisting of a critical care paramedic and a critical care nurse. Neurology evaluation occurs via telemedicine. The mobile stroke unit is equipped with IV alteplase. Data is collected EMS EMR and imported to stroke database. Inclusion criteria includes: 18 years or older, receive treatment in mobile stroke unit or emergency department, treated with IV alteplase.
Results: Ischemic stroke patients cared for by the Mobile Stroke Unit received IV alteplase (n=4) 25 minutes faster from time of dispatch than patients arriving to the Emergency Department (n=7). 100% of mobile stroke unit patients treated with IV alteplase had a 90 day modified rankin score of 2 or less (n=2) compared to 66% in the Emergency Department group (n=3). Symptomatic intracranial hemorrhage rate was 0% in both groups.
Conclusions: Patients treated in the mobile stroke unit demonstrate a decrease in time to treatment and a preliminary improvement in outcomes. Data is not significant at this time due to small sample size, however, the data is encouraging and should continue to be studied. In conclusion, the use of a mobile stroke unit in a suburban setting provides a time to treatment benefit.