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 MSTU if the patient is in the area of coverage. Currently, a MSTU operates out of Manhattan at NewYork-Presbyterian/Weill Cornell Medical Center on East 68th Street and NewYork-Presbyterian/Columbia University Irving Medical Center on West 168th Street. On April 30, a second unit began serving the community surrounding NewYork-Presbyterian Queens, and beginning May 28, a third unit will deploy in the community around NewYork-Presbyterian Brooklyn Methodist Hospital.
The vehicle is staffed by two highly specialized NewYork-Presbyterian paramedics, certified by the Regional Emergency Medical Services Council of New York City, a computed tomography (CT) technologist, and a registered nurse. A neurologist is consulted remotely via videoconferencing, an advancement that allows the physician to speak with and view the patient and provide an assessment and recommendations for care. It is designed to significantly reduce the time from the onset of symptoms to the delivery of care, a crucial factor in improving stroke outcomes.
“We now have a 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 read it.
To date, the MSTU has been deployed 454 times, transported 88 patients, and administered tPA 34 times. Since its launch in 2016, the MSTU has been able to treat stroke victims approximately 40 minutes faster than a standard ambulance transport.
“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.”