Special ER on Wheels Can Help You Survive a Stroke

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Nearly 2 million brain cells are lost for every minute that passes when you are having a stroke.

This makes time is a critical element in stroke treatment. How quickly treatment begins can impact how well you recover.

A stroke occurs when a blood vessel in the brain becomes blocked or bursts. There are two types of stroke: hemorrhagic and ischemic. A hemorrhagic stroke occurs when brain arteries rupture. An ischemic stroke occurs when blood supply to part of the brain is cut off.

Two new studies, one from Cleveland Clinic and another from University of Texas Health and Science Center at Houston, show how a special stroke ambulance can reach people having a stroke more quickly, administer treatment faster and improve outcomes. The research was presented recently at the American Stroke Association’s International Stroke Conference in Nashville, Tenn.

Saving time and lives

“Our ability to get to that patient and deliver treatment from the time of that first alarm is significantly improved,” says M. Shazam Hussain, MD, Head of the Stroke Program at Cleveland Clinic’s Cerebrovascular Center and lead researcher for one of the studies.  “We can sometimes save upwards of 30 or 40 minutes in terms of time to treatment.”

The ambulance, called a Mobile Stroke Treatment Unit, is essentially a specialized stroke emergency room on wheels. The unit has a computed tomography (CT) scanner on board to first diagnose whether someone is having a hemorrhagic bleeding stroke or an ischemic stroke where a blood clot is blocking blood flow to the brain. Stroke experts are then consulted via video conference to evaluate the patient and review images from the CT scan before treatment begins.

“What we’re able to do is to get right to the scene where someone is having their stroke and deliver treatment right there in the field,” Dr. Hussain says.

Avoiding delays

Study results show that CT scans were done faster on the Mobile Stroke Treatment Unit and patients were taken directly to the most appropriate hospital for their condition instead of the nearest. This avoided more treatment time delays as the patient is transferred from one hospital to another.

For strokes involving a blood clot, a clot-busting treatment called tPA was given sooner in the stroke ambulance than would have been in traditional treatment at the hospital.

Being able to give tPA quicker is significant because stroke patients have a window of about four and a half hours from when stroke symptoms start during which tPA is most effective in breaking up the clot and saving brain tissue.

“You can  see almost a two-and-a-half fold improved outcome when patients receive tPA treatment quickly as compared to later,” Dr. Hussain says.

Each year nearly 800,000 Americans experience a new or recurrent stroke, which is the nation’s third leading cause of death. Stroke is the leading cause of serious, long-term disability in the United States, with about 6.5 million stroke survivors alive today.

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