Friday, August 31, 2018

Mobile Stroke Units

Acute stroke is one of the main causes of death and chronic disability globally. In acute stroke management
‘time is brain’; thrombolysis with recombinant tissue plasminogen activator within the first hours after onset of symptoms is an effective therapeutic option for ischemic stroke.
 Professor Klaus Fassbender from Homburg an der Saar suggested over 20 years ago to bring the hospital to the patient. This has become a reality in the form of mobile stroke units. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and appropriate medication. Studies of prehospital stroke treatment consistently report a reduction in delays before thrombolysis and cause-based triage in regard to the appropriate target hospital (e.g., primary vs comprehensive stroke centre).

Earlier this year the Royal Melbourne Hospital launched an $8 million pilot project, hosting the first Mobile Stroke Unit in the southern hemisphere.

There are only a dozen Mobile Stroke Units currently operating in the world. All are in the northern hemisphere – including three in Germany and five in USA
The Mobile Stroke Unit team is shown with Andrei Alexandrov, and Anne Alexandrov, the IAC representatives and Dr. Ken Brown, UTHSC’s executive vice chancellor and chief operations officer. This photo belongs to the The University of Tennessee Health Science Center.  
In Houston USA, 70 percent of patients were treated within 90 minutes of symptoms including 40 percent in the first hour, compared to less than one percent of hospital-treated stroke patients being treated in the first hour

We’ve had a real focus on these innovative trials at the World Stroke Organisation, publishing a module on theWorld Stroke Academy, earlier in the year we interviewed Professor James Grotta for a PODCAST for the International Journal of Stroke
as an accompaniment to the article The PRE-hospital Stroke TreatmentOrganization.

Here are some of the MSU published articles in IJS.

Air-Mobile Stroke Unit for access to stroke treatment in rural regions.

Translation of the 'time is brain' concept into clinical practice: focus on prehospital stroke management.

Dr Silke Walter with the MSU team at
Southend on the Sea. 

Dr Silke Walter with the MSU team at
Southend on the Sea. 
Dr Silke Walter with Geoffrey Donnan
and Stephen Davis from the Melbourne Unit launch.
Dr Silke Walter, Skye Coote and
Managing Editor IJS Carmen Lahiff-Jenkins.

Sharon McGowen, CEO National Stroke Foundation
and Ned Lipes from Medtronic.

Dr Silke Walter, Peter Newbry and a rep from Medtronic.

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