Are they fast enough to get 100% recovery? If not; COMPLETE FUCKING FAILURE!
The only goal in stroke is 100% recovery; if you're not there, GET THE HELL OUT OF STROKE! I take no prisoners in getting stroke solved, so if not following me; GET LOST!
Mobile Stroke Units Enable Hyperacute Interventions for Intracerebral Hemorrhage
Abstract
BACKGROUND:
Mobile
stroke units (MSUs) aim to expedite acute stroke management when
compared with conventional emergency medical services (EMS). Despite the
growing body of evidence surrounding MSUs and acute ischemic stroke,
experience with intracerebral hemorrhage (ICH) in MSUs has been lacking.
We aimed to evaluate the impact of MSU transportation, compared with
EMS, on times to diagnosis and goal-directed treatment in patients with
ICH.
METHODS:
Retrospective
analysis of patients with acute ICH triaged by MSU or EMS from January
2018 to December 2022 was performed at 2 tertiary institutions, the
Cleveland Clinic (OH) and Stony Brook University (NY). In the EMS
cohort, only patients seen between 08:00 and 20:00, corresponding to the
operating hours of MSU, were included. Primary outcomes included
diagnosis by computed tomography, administration of antihypertensives,
and time to goal systolic blood pressure (<160 mm Hg). Analyses
included descriptive statistics and multivariable regression modeling of
log-transformed time metrics, adjusting for important patient
demographic and clinical characteristics.
RESULTS:
Among
540 patients screened with ICH, after removing those with exclusion
criteria, 218 MSU patients were compared with 192 EMS patients. Cohorts
had similar baseline demographics, majority male (53.7% MSU versus 49.5%
EMS), mean age 67±14 and 68±16, respectively. MSUs reduced time to
diagnosis by 28% (β=0.72 [95% CI, 0.62–0.82]; P<0.001).
Antihypertensives were administered to 78% of MSU patients, whereas not
routinely given to EMS-transported patients until emergency department
arrival. This facilitated a time reduction of 54% in the administration
time of antihypertensive medications in MSU compared with EMS
transported patients (β, 0.46 [95% CI, 0.36–0.59]; P<0.001).
With 87% of MSU patients achieving blood pressure goal within 1 hour
from last known well, compared with 60% in EMS (P<0.001).
CONCLUSIONS:
MSUs provide faster diagnosis and medical treatment for patients with acute ICH than patients transported by conventional EMS.
Graphical Abstract
No comments:
Post a Comment