Enhanced dispatch and rendezvous doubles the catchment area and number of patients treated on a mobile stroke unit

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Stephanie A ParkerJames C Grotta

Abstract

Mobile Stroke Units (MSUs) deliver acute stroke treatment on-scene in coordination with Emergency Medical Services (EMS). One criticism of the MSU approach is the limited range of a single MSU. The Houston MSU is evaluating MSU implementation, and we developed a rendezvous approach as an innovative solution to expand the range and number of patients treated. In addition to direct 911 dispatch of our MSU to the scene within our 7-mile catchment area, we empowered more distant EMS units to activate the MSU. We also monitored EMS radio communications to identify possible patients. For these distant patients, the MSU met the EMS unit en route to the stroke center and treated the patient at that intermediate location. The distribution of the distance from MSU base station to site of stroke and time from 911 alert to tissue plasminogen activator (tPA) bolus were compared between patients treated on-scene and by rendezvous using Wilcoxon rank sum test. Over 4 years, 338 acute ischemic stroke patients were treated with tPA on our MSU. Of these, 169 (50%) were treated on-scene after MSU dispatch at a median of 6.4 miles (IQR 6.4 miles) from MSU base station. 169 (50%) were treated by 'rendezvous' pathway with assessment and treatment of...Continue Reading

Citations

May 27, 2021·Journal of Neurology, Neurosurgery, and Psychiatry·Klaus FassbenderJames Grotta
Aug 27, 2021·Journal of Neurointerventional Surgery·Anne W AlexandrovAndrei V Alexandrov
Oct 13, 2021·Journal of Telemedicine and Telecare·Stephen W EnglishBart M Demaerschalk

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