Innovations in Prehospital Stroke Management Utilizing Mobile Stroke Units.

@article{Alexandrov2020InnovationsIP,
  title={Innovations in Prehospital Stroke Management Utilizing Mobile Stroke Units.},
  author={Anne W. Alexandrov and Andrei V. Alexandrov},
  journal={CONTINUUM: Lifelong Learning in Neurology},
  year={2020}
}
Using a representative case, this article discusses prehospital innovations for patients with acute large vessel occlusion ischemic stroke, including mobile stroke unit care supported by advanced field imaging. 
4 Citations
Impact of mobile stroke units
TLDR
Current research, therefore, focuses on safety, long-term medical benefit, best setting and cost-efficiency as crucial determinants for the sustainability of this novel strategy of acute stroke management. Expand
Telemedicine-enabled ambulances and mobile stroke units for prehospital stroke management.
TLDR
While both the mobile stroke unit and mini-mobile stroke unit model are valid approaches to improve stroke care, the authors aim to compare these models based on costs, scalability, integration, and interoperability in order to guide prehospital leaders to find the best solutions. Expand
Update on Treatment of Acute Ischemic Stroke.
TLDR
Timely successful reperfusion is the most effective treatment for patients with acute ischemic stroke and recent evidence supports the expansion of the time window for reperfusions treatment in carefully selected patients. Expand
High-resolution CT with arch/neck/head CT angiography on a mobile stroke unit
TLDR
MSU use of advanced imaging including multiphasic head/neck CTA is feasible, offers high LVO yield and enables full emergency department (ED) bypass and enabling full ED bypass. Expand

References

SHOWING 1-10 OF 25 REFERENCES
Improved Prehospital Triage of Patients With Stroke in a Specialized Stroke Ambulance: Results of the Pre-Hospital Acute Neurological Therapy and Optimization of Medical Care in Stroke Study
TLDR
The triage of patients with cerebrovascular events to specialized hospitals can be improved bySTEMO ambulances, and there was a slight trend toward higher rates of patients discharged home in neurological patients when cared by STEMO. Expand
Telemedicine in Prehospital Stroke Evaluation and Thrombolysis: Taking Stroke Treatment to the Doorstep.
TLDR
An MSTU using telemedicine is feasible, with a low rate of technical failure, and may provide an avenue for reducing the high cost of such systems. Expand
Effect of the use of ambulance-based thrombolysis on time to thrombolysis in acute ischemic stroke: a randomized clinical trial.
TLDR
To determine the effect of prehospital thrombolysis for acute ischemic stroke administered in specialized ambulances on delay in thROMbolytic administration, throm bolysis rate, post-thromBolysis intracerebral hemorrhage, and 7-day mortality. Expand
Effects of golden hour thrombolysis: a Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) substudy.
TLDR
The use of STEMO increases the percentage of patients receiving thrombolysis within the golden hour, which entails no risk to the patients' safety and is associated with better short-term outcomes. Expand
Emergency Department Door-to-Puncture Time Since 2014.
TLDR
DTPT decreased at a faster rate for EMS compared with MSU-managed patients, improving by about an hour from 2014 to 2018, and there is substantial room for improvement in all groups. Expand
Diagnosis and treatment of patients with stroke in a mobile stroke unit versus in hospital: a randomised controlled trial
TLDR
For patients with suspected stroke, treatment by the mobile stroke unit substantially reduced median time from alarm to therapy decision, and the MSU strategy offers a potential solution to the medical problem of the arrival of most stroke patients at the hospital too late for treatment. Expand
"Mobile stroke unit" for hyperacute stroke treatment.
TLDR
Experimental studies show that within minutes after vascular obstruction, cell death occurs in the core of the focal ischemic brain tissue, and in the region around this core (penumbra), cells exhibit a compromised metabolism but might be rescued by adequate therapies. Expand
Reducing in-hospital delay to 20 minutes in stroke thrombolysis
TLDR
Efficacy of thrombolytic therapy for ischemic stroke decreases with time elapsed from symptom onset, and with multiple concurrent strategies it is possible to cut the median in-hospital delay to 20 minutes. Expand
The PRE-hospital Stroke Treatment Organization
TLDR
The evidence supporting pre-hospital stroke treatment, progress to date, practical issues such as application in various environments and staffing, planned research initiatives, and organizational structure are described. Expand
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
TLDR
These guidelines supersede the prior 2007 guidelines and 2009 updates and support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. Expand
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