The First Mobile Stroke Treatment Unit on the East Coast
If you or a loved one suffers a stroke, time is of the essence. The sooner you receive lifesaving care, the less likely you are to experience death of brain tissue and the better chance you'll have of achieving a successful outcome. NewYork-Presbyterian — in partnership with Weill Cornell Medicine, Columbia University Medical Center, and the Fire Department of New York (FDNY) — has launched the first Mobile Stroke Treatment Unit (MSTU) on the East Coast. The unit is deployed via the FDNY through New York City's 911 system.
The MSTU emergency vehicle is designed to provide immediate, specialized care to people who may be having a stroke — bringing NewYork-Presbyterian's advanced technologies, expert staff, and lifesaving stroke treatment to more people in need. The unit features:
- Experts on Board: Staffed by a highly specialized team of two paramedics from the Regional Emergency Medical Services Council of New York City (REMAC), a computed tomography (CT) technologist, and an RN specially trained for stroke care, the MSTU will greatly reduce the time from the onset of symptoms to the delivery of care — a crucial factor in improving stroke outcomes. The crew connects with a board-certified neurologist who performs a telemedicine consult remotely from one of our hospital locations. The patient and crew are able to see, hear and interact with the neurologist through on-board monitors and microphones.
- Advanced Technologies at the Ready: The MSTU is complete with a portable CT scanner that can image a patient’s brain on the spot to determine the type of stroke the person may be having. The CT scan is then wirelessly transmitted to NewYork-Presbyterian, where a neuroradiologist evaluates it in real-time to make an accurate diagnosis.
- Effective Treatments, Fast and Available: The unit also contains equipment and medications to treat strokes, including tPA — a medication that works by dissolving a blood clot and improving the flow of oxygen-rich blood to the affected part of the brain. On occasion, the on-board CT scanner will demonstrate intracranial hemorrhage, which cannot be treated with tPA. In these instances, the MSTU can benefit the patient by offering earlier neurological consultation and advanced blood pressure management with intravenous medications with the aim of stopping the bleeding. Additionally, such information can be used, with approval of FDNY online medical control, to triage a patient to the closest hospital with the necessary neurosurgical team required to treat intracranial hemorrhages. We are planning to develop a number of other novel therapies for the future treatment of stroke in the field.
- Ready to Serve: The MSTU is deployed into the communities around NewYork-Presbyterian/Weill Cornell Medical Center at East 68th Street and NewYork-Presbyterian/Columbia University Medical Center at West 168th Street, and recently units have been deployed in both Brooklyn at NewYork-Presbyterian Brooklyn Methodist Hospital at 506 Sixth St., and Queens at NewYork-Presbyterian Queens at 56-45 Main St.
- Measuring Success: To determine the MSTU’s success, we will gather and analyze valuable data by following up with each patient after admission to the hospital. Our research will include patient outcomes at 90 days; the percentage of patients treated on the MSTU who made a full recovery compared with those delivered by standard EMS transport; and the overall cost of care. We also will work with similar units throughout the United States to combine data for a larger analysis.
Saad Abdul Sami Mir, MD, is an Assistant Professor in Clinical Neurology at Weill Cornell Medicine and Assistant Attending Neurologist at NewYork-Presbyterian/Weill Cornell Medical Center. He received his B.A. from Duke University and M.D. from University of Florida College of Medicine where he was inducted into Alpha Omega Alpha and the Gold Humanism Society. He was chosen as a Doris Duke Clinical Research Scholar, which he completed at University of Texas Southwestern Medical Center. Dr. Mir completed his internship at Massachusetts’s General Hospital, neurology residency at Massachusetts General Hospital and Brigham and Women’s Hospital, and vascular neurology fellowship at NewYork-Presbyterian/Weill Cornell Medical Center. Dr. Mir is board certified in Neurology and Psychiatry and is an expert in vascular and inpatient neurology. He is a LEAD Fellow at NewYork-Presbyterian Hospital where he will focus on becoming a leader in patient experience and patient reported outcomes. He is the Site Director for the Manhattan Mobile Stroke Treatment Unit at NYP/Weill Cornell.
Dr. Joshua Willey is an Assistant Professor of Neurology at Columbia University Vagelos College of Physicians and Surgeons and Assistant Attending Neurologist on the Stroke Service at NewYork-Presbyterian/Columbia University Medical Center. Dr. Willey received his undergraduate degree from Cornell University in 1999 and his medical degree from Columbia University in 2003. After a Neurology Residency at NewYork-Presbyterian/Columbia, he completed a two-year neuro-epidemiology and stroke fellowship at NYP/Columbia, and also earned an MS in epidemiology. He joined the faculty of Columbia University College of Physicians and Surgeons in 2009. He is the neurology residency associate program director. Dr. Willey has an outpatient clinical practice in neurology with a focus on cerebrovascular diseases and stroke, and attends on the inpatient stroke service. He is the Site Director for the Manhattan Mobile Stroke Treatment Unit at NYP/Columbia.
Babak Navi, MD, MS, is a vascular neurologist at NewYork-Presbyterian/Weill Cornell Medical Center, an assistant professor of neurology at Weill Cornell Medicine, and medical director of the Cornell Stroke Center. A native New Yorker, Dr. Navi earned his medical degree from New York University, where he graduated with honors (Alpha Omega Alpha Society). He completed his residency in neurology at Weill Cornell Medical Center and was named chief resident in his final year. He served a two-year fellowship in vascular neurology at the University of California, San Francisco, where he also became certified in comprehensive neurosonology. Dr. Navi holds a masters of science in research from the Weill Cornell Graduate School of Medical Sciences. He has a clinical focus in the relationship between stroke and cancer and has published numerous studies in medical journals. He is the associate editor for the journal Neurohospitalist, and the Cornell principal investigator for the NIH-funded POINT trial.