Memphis Mobile Stroke Unit Saves Lives

By: Olivia Peterkin, The Commercial Appeal

A year after a mobile stroke unit hit the streets of Memphis, officials say it is saving lives by cutting the time it takes to treat stroke patients.

The University of Tennessee Health Science Center began using the 14-ton ambulance last year as part of a three-year controlled study. The unit has a CT scanner that can X-ray images of the brain, and is equipped to provide early fluids to stroke patients and dye blood vessels to determine the type of stroke the patient has had.

“The emergency room on average takes 40 to 50 minutes to do the things we do in 13 to 14 minutes,” said Dr.Andrei Alexandrov, UTHSC neurology professor, chairman of the neurology department and medical director of the stroke unit team.

“From the very first day it was very clear that this was winning technology.”

To date, the mobile stroke unit has transported 171 patients and has administered 35 treatments of alteplase, or tPA, a clot-busting medicine.

“The unit that we have is so sophisticated that for the short duration of the patient’s experience on the unit, it is the equivalent of an emergency room in a primary stroke center,” said Alexandrov.

Launched last April, the mobile stroke unit is in use 12 hours a day for seven days, every other week.

“On the weeks that we’re not running the unit, we monitor stroke calls in the city,” said Joseph Rike, director of the mobile stroke unit.

If there were patients that would have been treated by the stroke unit, the mobile unit team tracks their progress, and compares it to the timelines of similar patients in the stroke unit, said Rike.

To help determine the unit’s efficacy, nurses or researchers collect data that includes the patient’s medical record, whether medicine was administered, and the outcome of treatment.

Tennessee is in the stroke belt, a group of mostly southeastern states where rates of stroke are highest in the country. Shelby County’s stroke rate is 37 percent higher than the national average, according to a news release from UTHSC.

“Everything (on the unit) is done as fast as possible – with average times from arrival on the scene to medicine going into the vein – of about 13 to 14 minutes,” said Alexandrov, “which is three times shorter than current best times posted by some of the hospitals in the area.”

With a stroke being an extremely time-sensitive emergency – almost 2 million brain cells die every minute that blood flow is not restored to the brain – the quicker that a patient can get treatment, the better.

“Once someone recognizes that they or someone that is in front of them is having a stroke, how you spend the first hour from that moment largely determines how you will spend the rest of your life,” said Alexandrov.

The three-year trial is being done to convince programs like Medicare and other third-party payers that the mobile stroke unit is a safe and efficient way of transporting stroke patients.

“We want to show that we are faster than the routine way of transporting stroke patients by regular ambulances,” said Alexandrov.

The more than $3 million unit is one of three participating in te study; the other two being in Houston and Denver. The Memphis stroke unit team is projected to have the data it needs after successfully treating 300 patients over the course of the three-year trial.

“The emergency room on average takes 40 to 50 minutes to do the things we do in 13 to 14 minutes.”

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