ER on Wheels: Groundbreaking Approach to Stroke Care
BURLINGAME, Calif. –Experts estimate that every minute treatment for stroke is delayed can mean life or death for 2 million brain cells. Strokes are the fifth leading cause of death and the top contributor to long-term disability in the U.S., according to the Centers for Disease Control and Prevention.
In the Bay Area, not-for-profit Sutter Health’s Mills-Peninsula Medical Center is partnering to pilot a specially-equipped and -staffed ambulance, called a mobile stroke unit (MSU). The goal is to test whether bringing stroke diagnosis and treatment to patients—rather than waiting for them to arrive at the emergency department—improves outcomes.
Mills-Peninsula is the first hospital in Northern California to pilot a mobile stroke unit, joining medical centers in New York, Chicago, Cleveland, Houston, Denver and Los Angeles.
Mobile stroke units are staffed with stroke specialists who are able to travel quickly to patients, determine if the patient is having a stroke and prescribe immediate treatment in the field.
Mills-Peninsula is collaborating with AMR (San Mateo County’s 9-1-1 provider), the county’s emergency medical services agency (EMS), public safety communications (PSC) and local fire departments to operate the ambulance and outfit it with special equipment and staff. The MSU will be fully integrated into San Mateo County’s 9-1-1 dispatch system.
Though from the outside a mobile stroke unit may resemble a standard ambulance, MSUs are equipped with a CT scanner, which is critical for diagnosing stroke. There are two types of stroke—ischemic (clotting) and hemorrhagic (bleeding).
“You can’t make any decision until you diagnose what type of stroke the patient has,” says Joey English, M.D., Ph.D., medical director of Mills-Peninsula’s neuro-interventional surgery program. If it’s a clotting stroke, which occurs in about 85 percent of patients, medication will be administered to break up the clot. If it’s a bleeding stroke, the patient will be transported to the nearest stroke center.
Initially, a stroke neurologist will ride in the Mobile Stroke Unit. Six months into the pilot, the MSU team will have the ability to connect live via video teleconference with a stroke neurologist at Mills-Peninsula who can evaluate the patient and prescribe further treatment.
Data gathered through the Mills-Peninsula pilot will contribute to national efforts aimed at demonstrating the mobile stroke unit’s ability to:
- Reduce stroke-related disability and mortality
- Reduce the need for post-stroke rehabilitation and hospitalization
Mills-Peninsula plans to launch its mobile stroke unit service within San Mateo County by the end of the year, once test runs are complete.