When a person has a stroke, every second counts. Doctors have a short window to treat people if they are to recover fully. Doctors know how to intervene after a stroke, but they can’t always access patients within the time window needed to avoid injury to the brain.
This is where a mobile stroke unit comes in. This truck-like ambulance brings stroke treatment right to the patient, saving critical minutes. At the scene, patients can begin receiving treatments: CT scans, blood tests and if needed, they can begin receiving clot-busting drugs. These trucks are also equipped with video capabilities so that specialists can guide treatment as the patient is being transported to the hospital.
Two German medical centers have successfully launched mobile stroke units. These units allow for very agile medical treatment. From the time the alarm sounds for a stroke case, they’ve been able to begin treating patients within 32 minutes.
“That just blows away everything that we had been doing here in the U.S. at this point,” says Shazam Hussain, MD, Head of the Stroke Program at Cleveland Clinic’s Cerebrovascular Center.
U.S. hospitals are just beginning to test and use these units. Recently, Cleveland Clinic rolled out its own mobile stroke units by partnering with MetroHealth Hospital and Cleveland EMS.
The $1 million ambulance-like unit runs on a 12-hour-per-day trial basis, though doctors hope to soon expand to 24/7 service. The unit operates inside the City of Cleveland proper. The goal is to shave down treatment time in these critical stroke cases.
“We usually aim, from the time when the patient arrives at the doors of the hospital, to administer a clot-buster drug within 60 minutes,” Dr. Hussain says. “With a mobile stroke unit, we have been able to treat a patient within 11 minutes, which is one of the fastest times in the world.”
He says the concept of a mobile stroke unit isn’t new but became feasible as technology improved.
“What’s gotten it rolling now is the development of CT scanners and 4G broadband telemedicine equipment. This new, smaller technology fits inside the mobile trucks, which essentially act like a mobile emergency department,” he says.
The CT scanners in the mobile units are essential in telling the difference between two types of strokes: acute ischemic (when a clotted vessel blocks blood flow to the brain) and hemorrhagic (when strokes cause bleeding in the brain).
The two types require different treatments. Doctors use clot-busting drugs to treat the former. In the latter, they take steps to limit the bleeding, sometimes using medications to reverse blood thinners.
“For all types of strokes, we can do some intervention,” Dr. Hussain says.
It’s important to know how to identify the signs of stroke so you can call for help for yourself or someone else.
Traditionally, doctors tell patients to follow the American Heart Association’s (AHA) guidelines based on the acronym FAST:
But doctors now realize that when strokes hit the back of the brain, the most obvious symptoms often are dizziness and vision trouble. The AHA now uses the updated acronym BE FAST, which adds balance and eye problems to the list of signs.
“Those can also be signs of a stroke, and patients should seek medical attention,” Dr. Hussain says.