“Mobile Stroke Unit” for Hyperacute Stroke Treatment

Faßbender, Klaus; Walter, Silke; Liu, Yang; Muehlhauser, Frank; Ragoschke, Andreas; Kuehl, Sandra; Mielke, Orell

doi:10.1161/01.str.0000075573.22885.3b

Cited by 131 publications

(106 citation statements)

References 7 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…Fassbender and coworkers developed a "mobile stroke unit" equipped with CT to perform prehospital thrombolytic therapies if indicated in a rural area. 20,21 Recently, the prehospital acute neurological therapy and optimization of medical care in stroke patients (PHANTOM-S) study introduced the stroke emergency mobile unit to apply prehospital thrombolysis in the Berlin inner-city catchment area. 22 The stroke emergency mobile unit is an advanced life support ambulance equipped with a CT scanner, point-of-care laboratory, and a mobile telecommunication support for teleradiology and teleconferencing.…”

Section: Discussionmentioning

confidence: 99%

Telestroke Ambulances in Prehospital Stroke Management

Liman

Winter

Waldschmidt

et al. 2012

Stroke

100

View full text Add to dashboard Cite

Background and Purpose-Pre-and intrahospital time delays are major concerns in acute stroke care. Telemedicineequipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Methods-Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. Results-In

show abstract

Section: Discussionmentioning

confidence: 99%

Telestroke Ambulances in Prehospital Stroke Management

Liman

Winter

Waldschmidt

et al. 2012

Stroke

100

View full text Add to dashboard Cite

show abstract

“…4 -7 These scores were tested with medical professionals in primary care, emergency medical services (EMS), and emergency department physicians. 7 Recent developments such as the installation of a CT scanner and point-of-care laboratory in EMS ambulances 8,9 promise a complete diagnostic stroke workup required for thrombolytic treatment before transport to the hospital. The possibility of sending such special ambulances to stroke emergencies might enable new prehospital stroke treatments to be evaluated, for example, ambulance-based neuroprotective trials.…”

mentioning

confidence: 99%

Development and Validation of a Dispatcher Identification Algorithm for Stroke Emergencies

Krebes

Ebinger

Baumann

et al. 2012

Stroke

View full text Add to dashboard Cite

Background and Purpose-Recent innovations such as CT installation in ambulances may lead to earlier start of stroke-specific treatments. However, such technically complex mobile facilities require effective methods of correctly identifying patients before deployment. We aimed to develop and validate a new dispatcher identification algorithm for stroke emergencies. Methods-Dispatcher identification algorithm for stroke emergencies was informed by systematic qualitative analysis of the content of emergency calls to ambulance dispatchers for patients with stroke or transient ischemic attack (Nϭ117) and other neurological (Nϭ39) and nonneurological (Nϭ51) diseases (Part A). After training of dispatchers, sensitivity and predictive values were determined prospectively in patients admitted to Charité hospitals by using the discharge diagnosis as reference standard (Part B). Results-Part A: Dysphasic/dysarthric symptoms (33%), unilateral symptoms (22%) and explicitly stated suspicion of stroke (47%) were typically identified in patients with stroke but infrequently in nonstroke cases (all Ͻ10%). Convulsive symptoms (41%) were frequent in other neurological diseases but not strokes (3%). Pain (26%) and breathlessness (31%) were often expressed in nonneurological emergencies (6% and 7% in strokes). Part B: Between October 15 and December 16, 2010, 5774 patients were admitted by ambulance with 246 coded with final stroke diagnoses. Sensitivity of dispatcher identification algorithm for stroke emergencies for detecting stroke was 53.3% and positive predictive value was 47.8% for stroke and 59.1% for stroke and transient ischemic attack. Of all 275 patients with stroke dispatcher codes, 215 (78.5%) were confirmed with neurological diagnosis. Conclusions-Using dispatcher identification algorithm for stroke emergencies, more than half of all patients with stroke admitted by ambulance were correctly identified by dispatchers. Most false-positive stroke codes had other neurological diagnoses. (Stroke. 2012;43:776-781.)Key Words: algorithm Ⅲ diagnostic accuracy Ⅲ dispatch Ⅲ sensitivity Ⅲ specificity Ⅲ stroke E ffective acute stroke therapies such as intravenous thrombolysis and stroke unit treatment have been established over the last decades. 1 However, these treatment options are not available in all hospitals 1 and the effect of thrombolysis on functional outcome is time-dependent. 2,3 Early recognition of patients with acute stroke in the prehospital setting is helpful in triaging patients and increasing admission rates of patients with stroke to specialized facilities. Prehospital stroke scores have been developed to assist in identifying stroke and show acceptable sensitivity (between 66% and 91%) and positive predictive values (78% and 90%). 4 -7 These scores were tested with medical professionals in primary care, emergency medical services (EMS), and emergency department physicians. 7 Recent developments such as the installation of a CT scanner and point-of-care laboratory in EMS ambulances 8,9 promise a complete diagno...

show abstract

“…By these means, MSTUs may play a pivotal role in reducing the ischemic insult to the patient's brain, overall AIS morbidity and mortality, and societal cost for medical care, rehabilitation, and disability related to AIS. 3,16 After the idea for an MSTU was first proposed in Germany in 2003, the first MSTU became operational in Berlin in 2008. Data collected from early German MSTUs supported the feasibility of this mobile AIS treatment system and suggested MSTU deployment resulted in significantly decreased times to IV-tPA administration for the patient.…”

Section: Mobile Stroke Treatment Unitsmentioning

confidence: 99%

“…Data collected from early German MSTUs supported the feasibility of this mobile AIS treatment system and suggested MSTU deployment resulted in significantly decreased times to IV-tPA administration for the patient. 16 In the US, the first MSTU was established at the University of Texas at Houston Medical Center in 2014 in collaboration with Frazer Ltd. and Neurologica, makers of the portable CT machine CereTom. 24 A rapid succession of new MSTUs around the US followed: the Cleveland Clinic (2014), University of Colorado (Denver, 2015), Mercy St. Vincent Medical Center (Toledo, August 2015), University of Tennessee Health and Science Center (Memphis, 2016), and later in 2016 at both Rush University Medical Center (Chicago) and NewYorkPresbyterian Hospital (New York).…”

Section: Mobile Stroke Treatment Unitsmentioning

confidence: 99%

Application of emerging technologies to improve access to ischemic stroke care

Vuong

Carroll

Tackla

et al. 2017

Neurosurgical Focus

View full text Add to dashboard Cite

During the past 20 years, the traditional supportive treatment for stroke has been radically transformed by advances in catheter technologies and a cohort of prominent randomized controlled trials that unequivocally demonstrated significant improvement in stroke outcomes with timely endovascular intervention. However, substantial limitations to treatment remain, among the most important being timely access to care. Nonetheless, stroke care has continued its evolution by incorporating technological advances from various fields that can further reduce patients' morbidity and mortality. In this paper the authors discuss the importance of emerging technologies—mobile stroke treatment units, telemedicine, and robotically assisted angiography—as future tools for expanding access to the diagnosis and treatment of acute ischemic stroke.

show abstract

“Mobile Stroke Unit” for Hyperacute Stroke Treatment

Cited by 131 publications

References 7 publications

Telestroke Ambulances in Prehospital Stroke Management

Telestroke Ambulances in Prehospital Stroke Management

Development and Validation of a Dispatcher Identification Algorithm for Stroke Emergencies

Application of emerging technologies to improve access to ischemic stroke care

Contact Info

Product

Resources

About