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Friday, April 27, 2012

Mobile stroke unit to the rescue

German researchers tested whether using specialized stroke ambulances called 'mobile stroke units' (MSU) could improve the outcomes of stroke victims. Patients who got an MSU received stroke treatment about 40 minutes earlier than their counterparts who were treated the conventional way. In case you're wondering, forty minutes can make a big difference during a stroke.

The most common treatment for stroke is thrombolysis, which dissolves the blood clots. However, this procedure must be started within a narrow window of time. More than half of stroke victims do not reach the hospital in time for the treatment to be effective. Thus, there’s a need to find a quicker way to treat patients.

Each MSU included a paramedic, stroke physician and neuroradiologist. Their specialized ambulance contained a CT scanner so that they were equipped to start thrombolytic treatment right at the emergency site or in the ambulance.

Patients who called in with the symptoms of a stroke that had occurred within the past two and a half hours were randomly assigned to get a visit from an MSU or from a regular ambulance.  People who received the MSU began stroke treatment immediately, an average of forty minutes earlier than the conventionally treated patients who got a regular ambulance.

A couple of points about this study. First, the study did not discuss the outcomes of non-stroke patients who were treated by the MSU. Presumably some fraction of the time the unit would respond to someone who hadn't actually had a stroke. Would those people have been better off with a conventional ambulance? And second, the study was not blinded.  That is, the patients and the medical teams knew very well whether or not an MSU was involved.

If having specialized stroke responders turns out to be impractical, perhaps regular emergency care providers could be provided with more training and equipment to deal with strokes. A few minutes can make a big difference in stroke recovery.