When a call comes in to the New York City 911 system and an operator identifies that someone is likely experiencing a stroke, the operator will deploy the mobile unit if the patient is in the area of coverage. Currently, the unit operates out of NewYork-Presbyterian/Weill Cornell Medical Center on East 68th Street and NewYork-Presbyterian/Columbia University Irving Medical Center on West 168th Street.
The vehicle is staffed by a neurologist, two paramedics, and a computed tomography (CT) technologist. Plans are to have additional units in the future and begin a telestroke program, where a nurse on board would communicate with a neurologist in the hospital, who would examine patients via a two-way audio-visual system.
“Our goal is to have the neurologist sitting in a command center in the hospital, and that person can evaluate multiple patients at the same time,” says Dr. Fink. “Then the neurologist can direct the ambulance teams to give medications as needed.”
The unit is 2 feet longer than a regular New York City ambulance to fit a
CT scanner so the team can take brain scans in the ambulance and then wirelessly send them to the doctors at the hospital.
“We’re using three different wireless network services,” says Dr. Fink. “If one goes down, we’ve got two others in place.” It can take as little as five minutes to take a CT scan in the unit and have a radiologist at the hospital provide a reading of it.
To date, the Mobile Stroke Treatment Unit had been dispatched to 397 calls, transported 72 patients, and administered tPA 27 times. Because it takes 90 days to evaluate a stroke patient’s recuperation, the doctors are still analyzing the Mobile Stroke Treatment Unit’s impact on recovery.
“It’s a little early, but I can just tell you that preliminary results have been great,” says Dr. Fink. “Some of the patients that we treated early on with a thrombolytic drug literally went home from the hospital the next day completely recovered.”
Patients like Eliana have made quick recoveries thanks to their fast treatment.
Because of the fast response of the Mobile Stroke Treatment Unit and the medics’ ability to start all the procedures, medications, and exams in the ambulance, says Eliana, “by the time I got to the hospital I was stabilized already. The ‘damage’ was contained and minimized, and the rehabilitation process could start early.”
After two weeks of rehabilitation at home, she could walk and play music and had her movement back. And the song she was recording on the day of her stroke?
“I have finished the song and since had two live performances,” she says. “I am forever grateful for the crew of the mobile stroke ambulance and the care and treatment I received at NewYork-Presbyterian.”