In October 2016, NewYork-Presbyterian, in collaboration with Weill Cornell Medicine, Columbia University Medical Center, and the FDNY, launched the Mobile Stroke Treatment Unit (MSTU) to provide immediate, specialized care to patients who may be having a stroke.
The MSTU is the first emergency vehicle of its kind on the East Coast. It is designed to significantly reduce the time from the onset of symptoms to the delivery of treatment – a crucial factor in improving stroke outcomes.
“The most effective method in saving a stroke victim’s life is to diagnose and treat immediately after a stroke occurs,” said Dr. Matthew Fink, neurologist-in-chief and chief of the Division of Stroke and Critical Care Neurology at NewYork-Presbyterian/Weill Cornell Medical Center and the Louis and Gertrude Feil Professor and chairman of the Department of Neurology at Weill Cornell Medicine.
How the MSTU Works
Via the 911 system, the FDNY deploys the unit into communities surrounding NewYork-Presbyterian/Weill Cornell Medical Center at East 68th Street and NewYork-Presbyterian/Columbia University Irving Medical Center at West 168th Street.
The crew consists of two paramedics from the Regional Emergency Medical Services Council of New York City, a CT technologist and a neurologist.
On board are stroke medications including tPA (tissue plasminogen activator) and a portable CT scanner that can image the patient’s brain on the spot and wirelessly transmit the image to NewYork-Presbyterian, where it is promptly evaluated by a neuroradiologist.
The MSTU also contains on-board electronic medical records to seamlessly integrate the treatment in the unit with the hospital receiving the patient.
If ischemic stroke is detected, the on-scene neurologist will administer the clot-reducing medication tPA, which is only effective if administered within a 4.5 hour window of stroke symptom onset, and previously only available in the emergency department.NewYork-Presbyterian is also developing a number of other novel therapies for future treatment of stroke in the field.
In the first four months of operation (Oct 2016 – Jan 2017), the MSTU has transported 31 patients, of whom 16 (52%) were diagnosed with acute ischemic stroke. Of these patients, 8 were administered tPA. The MSTU reduced time from symptom onset to treatment by an average of 46.5 minutes. Seven of these tPA-treated patients were either discharged home or to an acute rehabilitation facility.
Two other patients were treated with a catheter-based clot extraction procedure after delivery to the hospital.To determine the MSTU’s long-term success, NewYork-Presbyterian is following up with each patient after admission to the hospital, and is combining its data with data from mobile stroke units across the country for a larger U.S. analysis.