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 a successful outcome.
NewYork-Presbyterian’s Mobile Stroke Treatment Unit (MSTU) vehicle--launched in partnership with Weill Cornell Medicine, Columbia University Irving Medical Center, and the Fire Department of New York (FDNY)--is designed to provide immediate, specialized care to people who may be having a stroke. The unit is deployed via the FDNY through New York City's 911 system.
Our MSTU emergency vehicle was the first of its kind on the East Coast. The new technology brought expert staff and lifesaving stroke treatment to more people in need in New York City. 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 greatly reduces 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. 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.
- Measuring Success: To measure the MSTU’s success, we gather and analyze valuable data by following up with each patient after admission to the hospital. Our research includes 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 work with similar units in 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 completed a LEAD Fellow at NewYork-Presbyterian Hospital where he focused on becoming a leader in patient experience and patient reported outcomes. He is the Associate Director of the NewYork-Presbyterian Mobile Stroke Unit Treatment Program.
Dr. Joshua Willey is an Associate 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 an associate professor of neurology and neuroscience and chief of the division of stroke and hospital neurology at Weill Cornell Medicine, and medical director of the Cornell Stroke Center. 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. Dr. Navi is the associate editor for the journal Neurohospitalist and an editorial board member for JAMA Neurology. He is the Acting Director of the NewYork-Presbyterian Mobile Stroke Treatment Program and Cornell principal investigator for the BEST-MSU trial, which demonstrated the benefit of mobile stroke units as compared to standard ED care.
Mobile Stroke Treatment Unit
Mobile Stroke Treatment Unit
Matthew E. Fink, MD
Neurologist-in-chief, NewYork-Presbyterian/Weill Cornell Medical Center