Mobile stroke units improve time to treatment, 3-month functionality

Why aren't we using these much much faster options?  Probably don't need a neurologist either.

Hats off to Helmet of Hope - stroke diagnosis in 30 seconds   February 2017

 

Microwave Imaging for Brain Stroke Detection and Monitoring using High Performance Computing in 94 seconds March 2017

 

New Device Quickly Assesses Brain Bleeding in Head Injuries - 5-10 minutes April 2017

The latest here:

Mobile stroke units improve time to treatment, 3-month functionality 

In Berlin, mobile stroke units equipped with CT for prehospital thrombolysis not only reduced time to treatment, but had higher rates of thrombolysis and reduced risk for disability and death in patients experiencing stroke.
According to findings presented at the International Stroke Conference, the availability of mobile stroke units significantly reduced the incidence of the primary outcome, which included disability, neurological deficits and death at 3 months based on the modified Rankin Scale score (OR = 0.74; 95% CI, 0.6-0.9), compared with conventional care.

However, the intervention did not improve the coprimary outcome of living at home, living in institutional care or death at 3 months (OR = 0.75; 95% CI, 0.56-1.01) compared with the usual care.(And this is because you blithering idiots are doing nothing to stop the neuronal cascade of death.)
“While we had anticipated better outcomes in the patients treated in the mobile stroke units, we are amazed by the magnitude of the effects,” Heinrich Audebert, MD, professor in the department of neurology and Center for Stroke Research at Charité Universitätsmedizin, Berlin, said in a press release. “It is obvious that clot-busting treatment is most effective if it is applied in the ultra-early phase of stroke, ideally within the first or ‘golden hour’ of symptom onset.”
In other findings, 60% patients with stroke who were picked up by a mobile stroke unit underwent prehospital thrombolysis compared with 48% of patients who received conventional care (standardized mean difference, 0.24; P < .001).
In addition, patients who were picked up by a mobile stroke unit had a median 20-minute faster alarm to treatment time (50 vs. 70 minutes; standardized mean difference, 0.59; P < .001) compared with conventional care.
“The earlier and more frequent thrombolytic treatment is probably responsible for the majority of effects,” Audebert said during the presentation. “But other effects may have contributed such as early neurological assessment by neurologists in the mobile stroke unit with continuous monitoring and complication management during the prehospital phase and also a second medical assessment when the patient arrived in the hospital.”
For this prospective, quasi-randomized trial, researchers compared functional outcomes of patients with stroke (mean age, 74 years) who requested medical dispatch during times with (7 a.m. to 11 p.m.) vs. without mobile stroke unit availability.
“Our conclusions are that there may be different ways to advance treatment into the prehospital field, but just waiting until patients arrive at hospital is not enough anymore,” Audebert said during the presentation. “It may be that we should, in the future, apply neuroprotective therapy as well.” – by Scott Buzby
Reference:
Audebert HJ, et al. LB5. Presented at: International Stroke Conference; Feb. 19-21, 2020; Los Angeles.
Disclosure: Audebert reports he received research grants from Bundesministerium für Bildung und Forschung, Deutsche Forschungsgemeinschaft, Innovationsfonds des Gemeinsamen Bundesausschusses, Pfizer and Stiftung Deutsche Schlaganfall-Hilfe and honoraria from Bayer Vital, Boehringer Ingelheim, Bristol-Myers Squibb, Novo Nordisk, Pfizer and Takeda.