Almost 2 million brain cells die per minute during an acute stroke. That’s why time is of the essence when it comes to treatment of stroke victims.
Dr. David Persse is the director of the City of Houston’s Emergency Medical Services. He spoke during a news conference in the Texas Medical Center.
“We have got to get to these patients quickly. We have to get to them with the right expertise. The decisions that are made are not simple, they have to be made by experts, and then if the green light is there to treat the patient, then we have to be able to do it right away.”
The University of Texas Health Science Center’s Mobile Stroke Unit will be able to do just that. A built-in CT scanner makes it possible. Dr. Elizabeth Noser is the co-director of the new mobile unit. She says once dispatched, the stroke team will examine the patient to see if it really is a stroke case.
“We would then literally put them into the ambulance. We would do the CT scan, which is critically important to make sure that there’s not blood or hemorrhage in the brain. We also have lab works that we have to do. We have to make sure that the patient’s blood is not thinned. And then if all those pieces come together — so the CT confirms that we think it’s an ischemic stroke, the blood work shows that the blood is not thin – then we would start the treatment with the tPA at that point.”
tPA stands for tissue plasminogen activator and is a clot-busting drug. To be most effective, patients should receive that drug within the first three hours of suffering a stroke — and the earlier the better.
Dr. James Grotta is the director of stroke research at Memorial Hermann and heads the new Mobile Stroke Unit.
“Right now, if you have a stroke in the city of Houston or anywhere, you have to be taken to the emergency department and be evaluated in the emergency department before you can get treated, and on average that takes over an hour for the assessment to occur in the emergency department.”
Starting this month, the mobile unit will go out on trial runs. Grotta says there’s no data yet on how receiving treatment within the first hour after a stroke affects a patient’s recovery.
“The only way we’ll know whether it improves outcome is to compare the standard management compared to this innovative approach. So one week we’ll dispatch the ambulance and one week we will not. We’ll still follow the patients and determine how they do and what are the added costs of deploying the ambulance during the on-weeks versus the off-weeks.”
The unit will respond to cases within a three-mile radius. The hope is to be able to eventually finance more mobile stroke units to cover the entire city.