Mobile units could transform stroke outlook

Published: 8 March 2017 at 12:00

Professor Iris Grunwald

Research looks into viability of modified ambulances to meet ‘golden hour’ target

The introduction of modified ambulances designed to assess and treat stroke patients could result in a huge increase in the number of people treated within the so-called “golden hour”, according to research published in The Lancet Neurology.

Professor Iris Grunwald, of Anglia Ruskin University, collaborated with colleagues at the University Hospital of the Saarland and the University of Texas to review the risks and benefits of the Mobile Stroke Unit (MSU), a concept being piloted to improve outcomes for stroke patients.

The research notes that one of the key barriers to recovery of stroke patients is the time taken for the patient to arrive at hospital and in-hospital delays. Previous studies put the number of patients arriving for treatment within three hours as between 15% and 60%.

However, trials using an MSU have shown that it took a median time of just 56 minutes from patients showing symptoms to a treatment decision, and only 35 minutes from emergency call to decision.

The MSU contains imaging, a point-of-care laboratory and a telemedicine connection with a hospital, as well as medication and assessment tools. With the MSU, stroke victims can now receive diagnosis and treatment at the site of emergency. The technology can also help the triage of the patient to the most appropriate hospital, cutting down the chance of a patient arriving at a hospital only to be transported to another more specialised centre.

Professor Grunwald, Director of Neuroscience at Anglia Ruskin University, said:

“At present, most patients arrive too late for effective treatment, meaning their chances of living independently following a stroke are reduced. Every six-minute delay is associated with a 1% reduction in the chances of the patient being able to live independently.

“MSUs are designed to provide stroke care at the patient’s home or wherever the patient is found. They have been shown to enable life-saving treatment for 60% of stroke patients within the ‘golden hour’ versus 4% in an optimised hospital pathway.”