Every 40 seconds, someone in the U.S. experiences a stroke. It’s the fifth leading cause of death and the top contributor to long-term disability. Strokes caused by blood clots (ischemic) or brain bleeds (hemorrhagic) deprive the brain of oxygen-rich blood. “With each minute that passes from the onset of stroke, about 2 million brain neurons die,” says Jeffrey Saver, MD, director, UCLA Comprehensive Stroke Center. “There’s a saying: Time lost is brain lost.”
To reduce time to treatment and improve patient outcomes, UCLA Health began testing a mobile stroke unit in September. The modified ambulance features mobile stroke-assessment tools, such as a CT scanner for on-scene head imaging. At present, a UCLA neurologist who is a stroke specialist rides in the MSU, along with a critical care nurse, a CT technologist and a paramedic. In the future, MSU staff will use telemedicine to enable a neurologist to remotely assess and diagnose the patient, as well as recommend treatment. Research indicates that this process is as effective as having a neurologist physically present.
Top row, from left: CT technologists Wilbur Petalver, Kevin Brown and Joon Seo. Middle row, from left: Edward Lynn, RN, May Nour, MD, PhD, Ann McNeil, MSN. Bottom row, from left: Jeffrey Saver, MD, Preston White, MHA, Rinka Shiraishi, RN, Jacquelyn Gates, BSN.
“The MSU stroke team diagnoses the type of stroke and initiates appropriate treatment, such as clot-busting medications for ischemic strokes or bleeding-reversal agents for hemorrhagic strokes. The patient is then transported to the nearest stroke center,” says May Nour, MD, PhD, medical director, UCLA Arline and Henry Gluck Stroke Rescue Program. “This ultra-fast treatment initiation is expected to help improve patients’ clinical outcomes. The process also ensures that we triage the patient to the nearest specific medical problem.”
UCLA Health is the first medical system in the Western U.S. to operate an MSU. The emergency vehicle is one of only 14 MSUs currently in operation or under development in the U.S. In addition, the UCLA Arline and Henry Gluck Stroke Rescue Program is one of five such programs participating in a national study evaluating whether MSU programs can improve stroke outcomes while remaining cost-effective.
“There are a lot of direct and indirect costs associated with stroke, including hospital stays, rehabilitation and lost income,” says Preston White, director, clinical neurosciences, UCLA Health. “By accelerating treatment, we expect to improve quality of life for patients while decreasing health care utilization costs.”
From left: Preston White, MHA, May Nour, MD, PhD, Jeffrey Saver, MD, and Ann McNeil, MSN.
The Arline & Henry Gluck Foundation donated funds to establish UCLA’s mobile stroke rescue program and its first MSU. Last June, the Los Angeles County Board of Supervisors contributed additional funds to help expand the pilot program’s reach to more communities. For now, the MSU responds to emergency calls for potential stroke patients within a 10-mile radius of Westwood or Santa Monica. In the future, the MSU will also service San Pedro and Long Beach. Additional service locations will depend on program results.
