(Cleveland) - In an effort to better help the 5,600 stroke patients hospitalized each year in Cuyahoga County, Cleveland Clinic will soon be bringing one of the first Mobile Stroke Units in the country to the city of Cleveland.
The goal of the Mobile Stroke Unit is to shorten the time between the onset of stroke-like symptoms and the delivery of “clot-busting” - or thrombolytic - drugs, which must be administered within three hours of when symptoms began or when the patient was last known to be well.
The unit resembles an ambulance on the outside, but inside it contains highly specialized staff, equipment and medications strictly used for diagnosing and treating strokes.
It will be equipped with a portable CT scanner that is capable of imaging the patient’s brain to detect the type of stroke they are experiencing.
The CT scans will be wirelessly transmitted to Cleveland Clinic neuroradiologists,who will decipher if the patient is experiencing a stroke, and if so, whether the stroke is ischemic (caused by a blood clot) or hemorrhagic (caused by a ruptured blood vessel). Meanwhile, stroke neurologists will access the patient’s symptoms via telemedicine technology while en route to the hospital.
A mobile lab will be able to test blood samples on board. If it is found that the patient is experiencing an ischemic stroke - which account for about 87 percent of all strokes - the on-board medical team can initiate intravenous (IV) tissue plasminogen activator (tPA) to attempt to break up the clot.
“Despite the fact that tPA has been FDA approved to treat stroke patients for almost 20 years, it is still underutilized. Even across our Cleveland Clinic Health System, which includes three Comprehensive Stroke Centers, six Primary Stroke Centers and five Stroke Ready Centers, only 15 percent of patients arrive within the three-hour time window for intravenous tPA, making delay in presentation the most common reason patients were ineligible for this life-saving treatment,” said Peter Rasmussen, M.D., Director of Cleveland Clinic’s Cerebrovascular Center. “We care for more than 3,000 stroke patients on an in-patient basis each year, and if we can reach these patients faster by going directly to them and administering the medication on scene, we have the potential to offer stroke patients better short-term and long-term outcomes.”
The Mobile Stroke Unit, which will be comprised of a paramedic, a critical care nurse, a CT technologist and an EMS driver, will be integrated into the 9-1-1 dispatch system in the city of Cleveland. If the 9-1-1 dispatcher believes after asking a series of questions that a patient is experiencing stroke-like symptoms, crews from both Cleveland EMS and Cleveland Clinic’s Mobile Stroke Unit will be dispatched to the scene.
Upon receiving the treatment, the patient will be transported to the closest primary stroke center. The unit will be housed at Cleveland Clinic’s main campus in Cleveland. Cleveland Clinic Critical Care Transport employees will also be cross-trained to be able to work on the new unit.
This is being made possible with support from the Maltz Family Foundation of the Jewish Federation of Cleveland. Their $1 million gift will support the Mobile Stroke Unit in Cleveland and research to study how the unit affects patient outcomes.
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(Photo by Cleveland Clinic)