The Need for Mobile Stroke Care
Stroke is one of the leading causes of death and disability worldwide. Timely treatment is crucial for stroke patients to receive the best possible outcome and recovery. However, many communities lack adequate access to emergency stroke care facilities, facing barriers such as long travel times and distances to reach the nearest hospital. This delay in receiving treatment greatly reduces the chances of survival and functional recovery for stroke patients. To help bridge this access gap, especially in rural and remote areas, the concept of mobile stroke unit was introduced.
How It Work ?
A Mobile Stroke Unit is an ambulance specially equipped with on-board diagnostic technologies and trained medical personnel capable of delivering acute stroke treatment on location. It comprises of a conventional ambulance retrofitted with a computed tomography (CT) scanner, laboratory testing equipment, telestroke capabilities and medications for stroke thrombolysis. The team usually consists of at least one vascular neurologist, stroke nurse, emergency medical technician and driver.
When a call is received regarding a possible stroke, the mobile stroke unit is immediately dispatched to the patient's location. On arrival, a rapid neurological assessment is performed using scales like NIH Stroke Scale to determine severity and symptoms. Relevant blood tests and brain CT scan are done on board to confirm diagnoses and rule out any bleeds or other differential diagnoses. The scans can be immediately reviewed by a neurologist via telemedicine link. If eligible, thrombolysis medication is administered within the golden hour period to break up any blood clots in the brain. Vital signs and neurological status are closely monitored during and after treatment. The patient is then transported to the nearest stroke center for further management and care.
Benefits
These mobile facilities play a vital role in expanding access to lifesaving stroke care in underserved communities and regions. Some of the key advantages include:
- Reduced time to treatment: By bringing the essential diagnostic tools and therapies to the patient directly, mobile stroke units can substantially decrease time to thrombolysis. This translates to better outcomes.
- Reach rural populations: They can effortlessly navigate varied terrains to reach even remote villages and areas not easily accessible by ground ambulances. This improves treatment rates in rural stroke belts.
- Bypass transport time: Time spent in traditional ambulance transport to the nearest hospital is avoided. Every lost minute diminishes chances of survival and recovery.
- Early diagnosis: On-site CT scanning allows quick distinction of stroke subtypes and confirmation prior to administration of fibrinolytic drugs.
- Monitor treatment response: Continuous monitoring during transport to stroke centers optimizes safety and efficacy of interventions begun in the field.
- Cost-effective solution: They offer a relatively affordable solution to bridge the gaps without requiring infrastructural investments for permanent facilities.
Global Mobile Stroke Programs
Encouraged by their promising results, several countries and regions across the world have implemented its programs tailored to their needs and resources. Here are some examples:
Germany: Pioneering the concept, Germany established Europe's first unit in Berlin in 2010. Over a decade of operations, it has treated thousands of patients, substantially reducing time to thrombolysis.
United States: Programs have been launched in cities like Houston and New Jersey in partnership with local EMS and hospitals. Studies show significant reductions in door-to-needle times.
Canada: A mobile stroke unit pilot project was initiated in Greater Toronto Area in 2018 in collaboration with municipal EMS services and hospitals.
Australia: Melbourne introduced its units in 2021, operating 7 days a week to serve a population of over 5 million people in the state of Victoria.
South Asia: Non-profit groups have customized cheaper mobile stroke solutions for low-resource settings like rural India using basic diagnostic tools and telemedicine for supervision.
While programs and vehicles may differ, they collectively aim to facilitate equitable delivery of timely acute stroke care to populations wherever they may be located. Wider implementation worldwide especially in underdeveloped regions holds promise to bridge critical access gaps to potentially save many lives and disabilities.
As technology continues to progress, mobile stroke care delivery models are also evolving to integrate newer opportunities:
- Telestroke apps: Allowing real-time stroke assessments and e-prescriptions remotely in areas with limited specialist access.
- AI aided diagnostics: Incorporation of artificial intelligence and machine learning for automated interpretation of scans and testing can expedite diagnosis and treatment decisions in the field.
- Drone deliveries: Exploring feasibility of drones to transport thrombolytic medications directly to paramedic teams at stroke sites in hard-to-reach locations to minimize delays.
- Ambulance routing: Use of GPS and algorithms to determine most efficient prehospital routes and destination hospitals based on traffic, times and capacities.
- Ambulance-based rehabilitation: Future vans may feature hyperacute rehabilitation capabilities to provide immediate post-stroke therapies at home directly after the event.
Overall, with continued innovation and cooperation between EMS, medical communities and policymakers, mobile stroke care delivery is poised to play a crucial role in shaping equitable access to timely emergency stroke treatment across the globe in the decades ahead.
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About Author:
Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
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