Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, July 29, 2023

Mobile Stroke Units: The Barriers to Timely tPA Administration in the US

Well your first barrier is delivery in 3 minutes. Bet you can't do that. 

Electrical 'storms' and 'flash floods' drown the brain after a stroke

 

In this research in mice the needed time frame for tPA delivery is 3 minutes for full recovery. CAN YOU DO THAT? Since no one can do that, what are the followup procedures that will still deliver 100% recovery?

Don't allow your hospital to use the tyranny of low expectations to drive their goals for stroke recovery. The only goal in stroke is 100% recovery. You may need to scream at your stroke medical 'professionals' to get them to understand that. 

The latest here:

Mobile Stroke Units: The Barriers to Timely tPA Administration in the US

Allison Nguyen
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Close-up-of-the-interior-of-furnished-mobile-stroke-unit-with-medical-equipment.
Emergency mobile stroke unit. Ambulance van furnishes services to diagnose stroke patients.
Two neurologists discuss the barriers to timely tPA administration in acute stroke, including the implementation of mobile stroke units.

Stroke is one of the leading causes of death in the United States, with over 795,000 cases yearly. In particular, ischemic strokes have the highest prevalence, constituting 87% of all stroke cases.1

Early administration of tissue plasminogen activator (tPA) has proven to limit the risk for damage and functional impairment in patients with acute ischemic stroke.2-4 However, one of the most significant barriers to successful stroke management is administering tPA within the recommended window of 3 hours.5

The first mobile stroke unit (MSU) in the US was implemented in 2015 and allowed for earlier tPA administration, leading to significant improvements in functional outcomes for patients with stroke.

Recent pivotal studies, Berlin PRehospital Or Usual Delivery in Stroke Care (B_PROUD; ClinicalTrials.gov Identifier: NCT02869386) and Benefits of Stroke Treatment Delivered by a Mobile Stroke Unit Compared with Standard Management by Emergency Medical Services (BEST-MSU; ClinicalTrials.gov Identifier: NCT02190500), showed significant improvements in 90-day disability scores for patients with acute stroke treated on an MSU compared with emergency medical service (EMS) management in both Germany and the US. The B_PROUD study also showed that the median time from dispatch to initiation of thrombolysis for patients treated with an MSU was 20 minutes shorter than with conventional ambulances. 6,7(Still way too slow.) 

Essentially everything you need to do for a stroke is in the MSU.

While early studies show promising results for patients treated with MSUs, there are significant barriers to implementing and standardizing these services in the US. Many MSUs have not fully integrated into the existing EMS systems, making it difficult to streamline treatment processes. Additionally, most MSUs operate in densely populated cities. Research has suggested several methods for adapting these services to nonurban settings, such as air ambulances and various transport strategies, but further studies are necessary to prove these concepts.8,9

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