The University of Tennessee College of Medicine in Memphis, USA has introduced the world’s most comprehensive mobile stroke unit, designed to conduct and produce advanced quality imaging for stroke diagnosis and noninvasive computed tomography (CT) angiography with a Siemens Somatom Scope CT scanner.
According to a press release, this is the first time CT capabilities of this magnitude have been available in a mobile setting. This is intended to create the ability to diagnose and launch treatments, including tissue plasminogen activator (tPA) treatment and nicardipine within the first hour, and select patients for endovascular interventions, neurosurgery and neuro-critical care directly from the prehospital arena.
This unit is designed to prep a patient straight for the catheterisation laboratory, neuro intensive care unit or hospital stroke unit, bypassing a stop in the emergency department entirely.
“We are thrilled to have this medical first in Memphis. I want to stress that the mobile stroke unit is a product of worldwide industry leaders,” said David Stern, the Robert Kaplan Executive Dean and Vice-Chancellor for Clinical Affairs for The University of Tennessee College of Medicine and The University of Tennessee Health Science Center. “The vehicle framework is from Canada…the scanner was developed by a German company, the custom assembly took place in New York, with the oversight and direction coming from University of Tennessee College of Medicine in Memphis.”
The Mobile Stroke Unit, weighing in at more than 14 tons, includes features and capabilities such as:
- A hospital-quality CT scanner with advanced imaging capabilities to not only allow brain imaging, but also imaging of blood vessels in the brain.
- A dedicated gantry automatically moves the patient to obtain images, providing the same number of slices in high resolution as obtained and expected in the hospital setting.
- The unit is to be staffed with stroke fellowship-trained, doctorally-prepared nurses certified as advanced neurovascular practitioners.
- It is the largest mobile stroke unit in the world, complete with an internal power source designed to match regular electrical outlet access.
- The unit should transport trainees and researchers interested in the science of early stroke management.
“We have a tremendous burden of stroke in Shelby County, with a stroke rate per 100,000 population that is 37% higher than the national average*,” says Stern. “The goal of the mobile stroke unit is to minimise morbidity and mortality, to have more patients walk out of the hospital fully functional.”
“If we eliminate the treatment delay getting to and through the emergency room, we can save up to 90 minutes… Our hypothesis is that we will deliver hospital-level standard of stroke care faster, equally safe, but with better outcomes due to the ability to intervene much earlier,” says Alexandrov. “Our ‘time to treatment’ target is less than one hour.”
The mobile stroke unit is funded through a public-private collaboration for which more than US$3 million has been raised, which will enable operation for up to three years. The unit will operate 12 hours a day, one week on and one week off beginning late April 2016.
“The mobile stroke unit will be based in the heart of a 10-mile, most critical needs areas of Memphis with the highest incidence of stroke, but can be deployed within the entire metro region. We estimate that 300 patients will need to be treated by the Mobile Stroke Unit to prove its effectiveness over the course of three years,” says Alexandrov. “We believe this study will help establish a baseline of results that medical communities worldwide can use to develop and deploy similar programs to affect stroke outcomes.”