What is the Mobile Stroke Treatment Unit?
The Mobile Stroke Treatment Unit (MSTU) from NewYork-Presbyterian is a specially equipped ambulance that contains specialized staff, technology and medications specifically used for diagnosing and treating strokes.
Who staffs the Unit?
The crew consists of two New York City REMAC credentialed paramedics, a CT technologist and an RN specially trained in stroke care. 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.
What are the technologies and specialized equipment on board the Unit?
The MSTU brings an expert neurologist and the advanced technologies of an Emergency Room directly to the patient in a mobile setting. The ambulance is equipped with a computed tomography (CT) scanner, which will be used to rapidly evaluate patients who may be having a stroke. Additionally, laboratory tests routinely performed during emergency stroke care are available on the unit. The MSTU also contains wireless connectivity and on-board electronic medical records to seamlessly integrate the treatment in the unit with the hospital receiving the patient. If stroke is detected, the on-scene neurologist will administer potentially life-saving clot-reducing medication, or other medications specific to stroke care, previously only available in the emergency department.
What kinds of medications are administered in the MSTU?
If ischemic stroke is detected, the on-scene neurologist will administer clot-reducing medication, including tPA (tissue plasminogen activator). This medication works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood. tPA is most effective if administered within a 4.5 hour window of stroke symptom onset. The power of the MSTU is its ability to not only reduce the amount of wait time for the tPA drug, but also to swiftly bring treatment to stroke victims before that 4.5 hour window closes.
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.
Which specific areas does the Unit cover in New York?
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.
How is the Unit dispatched to help people who are having a stroke?
NewYork-Presbyterian has partnered with the FDNY to bring rapid treatment to New York City stroke victims. The FDNY has developed a dispatch pathway to direct the Unit to 911 calls within the coverage area when stroke is suspected.
What other NY agencies are involved in this project?
The FDNY is actively involved in the operations of the MSTU.
Does the Unit take patients to the hospital of their choice?
The Unit transports the patient to the nearest appropriate Stroke Center including NewYork-Presbyterian’s two different sites in Manhattan – NewYork-Presbyterian/Columbia University Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center. In Brooklyn patients are transported to NewYork-Presbyterian Brooklyn Methodist Hospital and in Queens to NewYork-Presbyterian Queens.
What happens if medical staff determines that the patient on the Unit is not actually having a stroke?
The patient will still receive medical care appropriate for their condition and be transported to the nearest hospital for further assessment.
Frequently Asked Questions about Strokes
What are the symptoms of a stroke?
The most common symptoms of stroke can be remembered by the acronym FAST:
F = Face: Is one side of the face drooping down?
A = Arm: Can the person raise both arms, or is one arm weak?
S = Speech: Is speech slurred or confusing?
T = Time: Time is critical!! Call 9-1-1 immediately!
What should you do if you notice someone exhibiting signs of a stroke?
Call 9-1-1 immediately! A stroke is a medical emergency.
Why do you have to act FAST?
Every minute counts when someone is having a stroke. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save people's lives and enhance their chances for successful recovery.