With a stroke patient, every second is precious, ticking closer toward disability or death. A new high-tech ambulance, first rolled out in Germany, is hitting the streets in the United States, and experts hope it will drastically improve outcomes.
Just recently, two medical centers in the Houston and Cleveland regions deployed mobile stroke units hoping to more quickly treat stoppages of blood flow to the brain. Memorial Herman Texas Medical Center in Houston launched the service last May, in conjunction with the work of several partners.
The ambulance is fitted with a mobile computed tomography scanner, and is staffed by a paramedic, neurologist, nurse and CT technician. By bringing the hospital to the patient, Memorial Hermann is able, when necessary, to quickly administer the brain clot-busting drug tPa, which is most effective when given within three hours.
Patients lose an estimated 2 million brain cells each minute after suffering a stroke, and any delay in treatment can prove costly, says M. Shazam Hussain, M.D., head of the stroke program at Cleveland Clinic, which debuted its unit in July. Stroke cases cost the nation some $38 billion each year.
“It’s a situation where every minute counts,” he says. “By using something like a mobile stroke unit, where you can actually take the emergency room to the patient, that substantially cuts down the time it takes to treat people. That should translate into, not only better outcomes for patients, but also lower costs to the health care system in general.”
German researchers demonstrated that the unit can get treatment to patients 36 minutes quicker, but experts are eager to see how it affects the results. “If this pans out, it could have a huge impact on outcomes,” says Jayme Zage, a Houston-based vice president with consultancy Sg2 and an expert in neurosciences. “The way we think about stroke care quality and access is primed to change if this proves itself, and that’s why this has me really excited.”
In the short time it’s been in operation, the Memorial Hermann unit — in collaboration with the University of Texas Medical School at Houston, local fire departments and others — is treating about two stroke patients a week. It gets treatment to more than 40 percent of patients within one hour, says James Grotta, M.D., director of stroke research at Memorial Hermann. The national average is less than 1 percent.
Certain hurdles stand in the way of widespread adoption, such as the $1 million in startup costs, which the Texas partners raised through philanthropy. Nevertheless, Grotta says, “this is the next quantum leap forward and people should not be deterred by what they think are either logistical or financial reasons. Neither of those considerations is insurmountable or any greater than anything else that we try in medicine that’s new.”