An ongoing study at Cleveland Clinic finds mobile stroke treatment units considerably more effective than traditional ambulance transport for timely evaluation and treatment of stroke. Preliminary data were presented at the American Stroke Associations International Stroke Conference 2015.
In July 2014, Cleveland Clinic launched a Mobile Stroke Treatment Unit to diagnose and treat stroke more quickly and effectively. The mobile unit is more than a standard ambulance. It contains all of the equipment and medical personnel necessary for treating stroke patients, including the CT scanner required to determine treatment for hemorrhagic versus ischemic stroke and telemedicine technology which allows two-way audio/video conferencing between the mobile unit crew and an in-hospital stroke specialist.
Patients treated in the mobile units experienced approximately a 40-minute reduction in the time to treatment when compared with the standard model of ambulance transport and in-hospital evaluation and treatment 64 minutes in patients transported by the mobile unit versus 104 minutes in emergency room patients.
In addition to the reduction of time-to-treatment, research results showed a reduction of time in CT scan completion by 21 minutes, and a higher rate (26 percent vs. 14 percent) of treatment using intravenous tPA was achieved.
Nationally, just 3 to 8 percent of patients receive tPA because it must be administered within 4.5 hours of the onset of stroke symptoms. Despite systemwide efforts over several years, tPA delivery times at Cleveland Clinic improved only somewhat prior to the implementation of the mobile stroke units.
For this study, 23 patients were treated in the mobile stroke unit group and 34 in the control group. A patient registry was created for three weeks following the launch of Cleveland Clinics mobile stroke treatment units, which was compared to the control group of patients brought to the emergency department by traditional ambulance for the preceding three months.
Due to how critical time is in the treatment of stroke, using mobile stroke treatment units to provide pre-hospital evaluation and treatment of stroke should revolutionize the care of these patients, said Muhammad Shazam Hussain, M.D., Head of Cleveland Clinics Stroke Program.
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