Introduction
A stroke is a medical emergency that requires immediate treatment to reduce brain damage and disability. Mobile stroke units (MSUs) were first introduced in clinical practice in 2008. They are rapidly expanding worldwide as they enable prehospital stroke treatment. The goal of mobile stroke units is to reduce the time between the onset of stroke symptoms and the administration of drugs within the first hour. The efficient treatment of acute stroke includes thrombolysis and intra-arterial therapy (IAT), which are time-sensitive. Mobile stroke units have the potential to deliver the treatments on time. Ongoing research is exploring their effectiveness and potential for stroke care.
What Is a Mobile Stroke Unit?
A mobile stroke unit is a specialized ambulance with advanced medical equipment and staff. The MSUs are designed to bring critical stroke care to patients in the field, allowing for faster treatment and better outcomes and reducing the risk of disability and death. MSUs are implemented in several cities and urban areas.
The MSU is typically staffed by a team of healthcare providers, including a paramedic or emergency medical technician, a critical care nurse, a CT technologist, and a neurologist who can remotely access and treat patients via telemedicine technology.
Who Requires a Mobile Stroke Unit?
Patients suspected of acute ischemic stroke due to blockage of a blood vessel supplying blood to the brain. The symptoms of acute ischemic stroke include the following.
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Numbness or weakness (sudden onset on one side of the body).
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Difficulty speaking.
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Difficulties in understanding.
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Sudden vision changes.
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Severe headache.
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Loss of balance and coordination.
The MSU is particularly required in situations where time is critical, such as in rural or remote areas where access to stroke care is limited or densely populated urban areas where traffic can cause delays in transporting patients to the hospital. The decision to use an MSU depends on various factors, such as the patient’s symptoms, the patient's location, and the MSU's availability.
What Are the Equipment Used in Mobile Stroke Units?
A mobile stroke unit is a specialized ambulance with advanced medical equipment that enables rapid diagnosis and treatment of stroke patients in the field. The equipment used in an MSU includes the following.
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Portable CT Scanner: MSU is equipped with a portable CT scanner, which can quickly and accurately diagnose the type of stroke and help guide treatment decisions.
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Laboratory Testing Equipment: The MSU is equipped with laboratory testing equipment that quickly evaluates blood samples and provides information on key indicators of stroke risk, such as glucose levels.
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Telemedicine Technology: The MSU is equipped with telemedicine technology, such as videoconferencing, allowing remote assessment and consultation with a neurologist or other stroke specialist.
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Thrombolytic Therapy: The MSU has a supply of thrombolytic therapy, a clot-busting drug used to treat ischemic stroke.
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Advanced Life Support Equipment: The MSU has advanced life support equipment, such as a defibrillator and medications, to manage cardiac and respiratory emergencies.
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Point-Of-Care Ultrasound: The MSU is equipped with a point-of-care ultrasound machine to help identify certain types of stroke and other medical conditions.
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Advanced Communication Tools: The MSU is equipped with advanced communication tools, such as satellite or cellular, allowing the team to communicate with the hospital and other healthcare providers in real time.
How Is a Mobile Stroke Unit Designed?
The design of a mobile stroke unit is focused on providing a self-contained clinical environment that can rapidly diagnose and treat stroke patients. Some key design features of an MSU include the following.
Self-Contained Environment: The MSU is designed to be a self-contained clinical environment with all of the equipment and supplies needed to diagnose and treat stroke patients on board. This includes advanced equipment such as scanners and specialized medications such as thrombolytics.
Size and Mobility:
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An MSU is typically a custom-built ambulance or large vehicle to accommodate the advanced medical equipment and staff needed to diagnose and treat stroke patients.
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The vehicle is designed to be highly mobile, allowing it to reach patients rapidly in a wide range of locations.
Ergonomic Design:
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The interior of the MSU is designed to be ergonomic and functional, with ample space for staff to move around and work efficiently.
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The design also includes features such as temperature control and soundproofing to ensure a comfortable and stable environment for patients and staff.
Safety Features:
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The MSU is designed with safety in mind, including features such as advanced life support equipment, secure storage for medications and supplies, and emergency backup systems in case of power or equipment failure.
What Are the Advantages of Mobile Stroke Units?
The advantages of mobile stroke units over traditional methods include the following.
Faster Treatment:
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The primary advantage of MSUs is that they enable faster treatment for stroke patients.
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By bringing advanced diagnostic and treatment capabilities directly to the patient, MSUs can significantly reduce the treatment time, which is critical for improving outcomes and reducing disability.
More Accurate Diagnosis:
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Mobile stroke units are equipped with advanced diagnostic equipment, such as CT scanners, that can quickly and accurately diagnose the type of stroke and guide treatment decisions.
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This can help ensure that patients receive the most appropriate treatment for their specific condition.
Improved Outcomes:
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Studies have shown that MSUs can improve outcomes for stroke patients, including reducing disability and improving survival rates.
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This is likely due to faster treatment and more accurate diagnosis provided by MSUs.
Cost-effective:
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Despite the advanced equipment and specialized staffing required to operate an MSU, studies show that MSUs can be cost-effective compared to traditional stroke care methods.
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This provides improved outcomes and reduced the need for long-term care.
Increased Access to Care:
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MSUs can provide stroke care in remote or underserved areas where traditional stroke care may be less accessible.
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This can help ensure that all patients have access to high-quality stroke care, regardless of their location or ability to travel.
What Are the Disadvantages of Mobile Stroke Units?
The disadvantages of mobile stroke units include the following.
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Limited staffing.
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Limited treatment options.
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Limited ability to operate in extreme weather conditions such as heavy rain or snow.
Conclusion
Mobile stroke units are still experimental in some areas of the world. An international collaboration is established to coordinate programs worldwide. The proportion of patients treated with MSU is small worldwide. Further research is needed to determine their long-term medical benefits in the healthcare environment, cost-effectiveness, and sustainability. Although mobile stroke units are currently used for stroke management, they may be used in the management of other neurosurgical and neurologic emergencies in the future.
