Ad campaigns in the community have improved awareness of cerebrovascular accidents, leading to faster responses from bystanders. Prompt arrival times from the ambulance are important in reducing the damage caused by a progressive neurological event, with standard practice being monitoring and assessment en route. Thrombolytic agents cannot be administered until a hemorrhagic stroke is excluded using CT. If the transit time could be used to image the patient’s brain, definitive treatment could be commenced earlier.
A Mobile Stroke Unit is an ambulance with an inbuilt CT scanner. On arrival of a Mobile Stroke Unit, a CT brain can be performed and images can be immediately viewed by a stroke neurologist through tele-health. Confirmation of an embolic stroke can allow specially trained paramedics to administer thrombolytics en route to the Emergency Department. Conversely, identifying a hemorrhagic stroke also allows a facility to better prepare for the patient’s arrival and a possible neurosurgical intervention.
The Mobile Stroke Unit is being trialled in Melbourne and has been operational since 2017. Previous pilot trials in the United States have shown good results from their active Mobile Stroke Units. If successful, it could greatly reduce the time to definitive treatment for stroke patients in the metropolitan area and improve health outcomes.
- Faster differentiation of stroke type allows earlier intervention and better outcomes
- Shorter recovery times for patients also equates to savings in hospital expenditure
- Expenses limit the operationalisation to metropolitan areas and not rural health where time to definitive care is longer
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