The Mobile Stroke Unit

[Scott Travis Harrell 1]

Great things are happening in the Texas Medical Center in Houston this week. The nation's first ambulance with an on-board CT scanner is rolling out.

[Jybehofd 85]

is this on the road yet? i saw this video a while back or something similar to it.

[EMT111 149]

It appears that the unit was officially/publicly unveiled this week. They are saying it's only respond in a three mile radius of the hospital. I have two problems with it. First, I'm assuming that the mobile CT scanner and whatever else extra this unit carries takes the place of some of the traditional equipment usually carried. So what happens if someone is in the mobile stroke unit and then something else happens and the stroke unit doesn't have that equipment because instead they elected to carry a mobile ct scanner? The only way I see around this problem is that since they respond with the FD, the FD medic unit would have to follow them into the ER in case they need equipment not on the mobile stroke unit. Bringing me to my second point. I will state that I have no knowledge of Texas or Houston EMS so this may be way off, but the fire department is gonna send a bill to the stroke patient, and so is the hospital for the mobile stroke unit. So, in a sense, the patient will pay the equivalent of at least two ambulance bills, though I'm sure the bill will be more with the mobile stroke unit. In my opinion, this is gonna be really costly for the patient's, the insurance companies won't like the high costs. and it'll be way too much for the hospitals to run, and we won't see them in mass production. Finally, if a patient is within a 3 mile radius of a stroke center, and they dial 911 as soon as they get the stroke symptoms, why is it taking them an hour to get treatment? Is traffic really that bad in Huston, or is the hospital really that backed up?

[BCFire05 83]

I've been keeping track of this and have talked to a few people. The Stroke unit has been Unveiled, it's a Frazer with a 12 ft box, CT scanner mounted where the captains chair is. It will carry full ALS supplies along with stroke drugs as well. The unit will be accompanied by HFD Ambulance and paramedics or whichever dept / EMS agency the residence is covered by. It will be the start of a 3 year clinical study to see if it is cost efficient and saves more stroke victims. Houston area hospitals hope that if it works, they can have up to 10 units placed strategically around the city after the trial is complete.

These are not my pictures. They are from Frazer's Facebook

[v85 212]

What is the staffing on the unit?

Also what are the dispatch protocols that it gets sent on? Any possible stroke symptoms within the window of time? If you have multiple pts with those symptoms, which one gets the unit?

[BM234 2]

I see this being more useful in extreme rural areas, not in a city environment. In a rural system this could influence transport times or even medevac use for stroke victims. But again, people that really need us often don't call us, and vice versa.

[BCFire05 83]

As far as protocols and staffing, I'm not sure. I would assume atleast someone with the hospital stroke team. Again you have to remember that this is a clinical trial. I'm sure more will be revealed when it goes into service.

I see this being more useful in extreme rural areas, not in a city environment. In a rural system this could influence transport times or even medevac use for stroke victims. But again, people that really need us often don't call us, and vice versa.

Harris county is quite large and a vast majority of the hospitals are centralized, especially the primary stroke centers such as St. Luke's.

HFD has stations as far out as 25 min from these stroke centers. So having a mobile unit that can verify a stroke on scene and immediately begin treatment with clot busters and whatever else could be very beneficial. I'm interested in seeing how well it works.

[BM234 2]

I'm all for it, especially having a clinical trial in a busier urban system.

[BCFire05 83]

Frazer has a new video giving more detail about the Mobile Stroke Unit.

Staffing is

1 - Paramedic

1 - Neuro Physician

1 - CT Nurse

1 - RN

http://www.youtube.com/watch?v=y1m64EL-k5I

Edited March 12, 2014 by BCFire05

[mfc2257 464]

Am I alone in thinking that this is not a financially viable unit.

[x635 4,066]

Hunter- thanks for sharing the updates with this! Neat to see this clinical research concept come to life.

This would come in great for when I used to work in parts Texas, in counties where it could take you an hour to get to the scene, and then another hour to get to the hospital

Houston has some of the best healthcare in the world.

[BCFire05 83]

Am I alone in thinking that this is not a financially viable unit.

That's part of the reason that it's all in clinical trial for the next 3 years. To see if it is cost effective and beneficial to stroke patients. It's an interesting study, one that's already been going on in Europe. Houston is a fantastic place to test this. Houston has some of the best stroke centers in the US. Honestly, some pediatric hospitals spend more on they're NICU/PICU ambulances than UT spent on this stroke unit.