Mobile Stroke Unit Now Available in NYC
NewYork-Presbyterian launched a stroke ambulance that will be the first of its kind on the East Coast.
NewYork-Presbyterian Hospital launched a new Mobile Stroke Treatment Unit ambulance specifically for stroke victims, which will be the first of its kind on the East Coast, the hospital said. The goal is to shorten the time for stroke patients to receive immediate, life-saving treatment at their doorsteps instead of traveling to the emergency room.
“The quicker we get to the patient, the more life-saving it could be,” said Dr. Steven Corwin, president and CEO of NewYork-Presbyterian. “Time is brain.”
Stroke is the fifth-leading killer in the U.S. where 795,000 people suffer from the disease each year, according to the American Stroke Association. Based in New York City, NewYork-Presbyterian treats more than 2,000 stroke cases every year, one of the highest volumes in the world. This makes the hospital “an ideal place to launch this patient-centered initiative,” said Dr. Olajide Williams, chief of staff of neurology and director of acute stroke services at Columbia University Medical Center.
When a stroke patient dials 911, the Fire Department will use an algorithm to analyze the symptoms before dispatching the unit. Developed in collaboration with Weill Cornell Medicine and Columbia University Medical Center, the vehicle is equipped with stroke care specialists, a computed tomography (CT) scanner and medications for treating stroke patients on-site.
Consistently ranked by the U.S. News and World Report as one of the best hospitals in America, NewYork-Presbyterian is among the 25 stroke centers funded by the National Institute of Health Stroke Clinical Trials Network to develop new treatments for stroke, Dr. Williams said.
NewYork-Presbyterian followed hospitals across the country to provide pre-hospitalization stroke treatment. University of Texas Health Science Center in Houston introduced the nation’s first mobile stroke unit in February 2014, followed by Ohio’s Cleveland Clinic in July 2014. Mobile stroke units now also operate in Denver, Colorado; Memphis, Tennessee; Chicago, Illinois; and Toledo, Ohio.
When asked if mobile stroke treatment has any potential shortcoming, Dr. Matthew Fink, chief of the stroke and critical care neurology division at Weill Cornell Medicine, told UpstartCity the limitations are “not so much what we can do at the site because we can do as much at the site as the emergency room can do.”
Most strokes are caused by sudden blockage of blood flow. Within three hours after symptoms appear, strokes can be treated by tissue plasminogen activator (tPa) drugs, which dissolve the clots blocking blood flow to the brain, according to the Centers for Disease Control and Prevention.
Expediting the delivery of tPa medication should, by logic, benefit stroke patients. However, citing a medical study from Germany, Dr. Mark Alberts argued that while mobile stroke units managed to reduce the time to treatment by 25 minutes, the “overall functional outcomes” remain to be proven. Weighing the financial costs and health benefits, it is also difficult to judge whether mobile stroke treatment is constructive across large populations.
“This mobile ambulance and the CT, just the infrastructure, cost well over $1 million,” Dr. Alberts, vice chair of clinical affairs at UT Southwestern Medical Center in Dallas, Texas, said in an article on Medscape. “Was it cost-effective to have a neurologist riding around Berlin and other cities?”
As patient data are transferred to the hospital on the road, hospital staff will have ample time to prepare for an operation that can be performed once the patient arrives, according to Dr. Fink from NewYork-Presbytarian. To assess the effectiveness of the mobile stroke ambulance, the hospital plans to analyze patient outcome after 90 days and compare the number of full recoveries to those achieved from standard emergency services.
The Mobile Stroke Treatment Unit commenced operation on Oct. 3 and will initially be serving neighborhoods around NewYork-Presbytarian campuses at East 68th Street and West 168th Street.