Article
Neurosciences
Ramnath Santosh Ramanathan, Dolora Wisco, Daniel Vela-Duarte, Atif Zafar, Ather Taqui, Stacey Winners, A. Blake Buletko, Fredrick Hustey, Andrew Reimer, Andrew Russman, Ken Uchino, M. Shazam Hussain
Summary: MSU has been proven to rapidly provide pre-hospital thrombolysis for acute ischemic stroke (AIS). However, about one third of MSU encounters were not AIS initially, including intracranial hemorrhage and stroke mimics, indicating the versatility and importance of MSU in treating emergent neurological conditions.
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
(2021)
Review
Chemistry, Multidisciplinary
Jun Sheng Kwok, Kate Fox, Cees Bil, Francesca Langenberg, Anna H. Balabanski, Angela Dos Santos, Andrew Bivard, Fergus Gardiner, Christopher Bladin, Mark Parsons, Henry Zhao, Skye Coote, Christopher Levi, Henry De Aizpurua, Bruce Campbell, Stephen M. Davis, Geoffrey A. Donnan, Damien Easton, Toh Yen Pang
Summary: Stroke, as the second leading cause of death globally, requires early treatment for improved patient outcomes. The concept of a mobile stroke unit (MSU) has been implemented to provide diagnosis and treatment during the ultra-early time window in the pre-hospital setting. However, most rural communities face challenges in accessing specialized stroke facilities. The aircraft counterpart (Air-MSU) offers a potential solution by expanding the catchment area in Australia.
APPLIED SCIENCES-BASEL
(2022)
Article
Multidisciplinary Sciences
Mahesh P. Kate, Thomas Jeerakathil, Brian H. Buck, Khurshid Khan, Ali Zohair Nomani, Asif Butt, Sibi Thirunavukkarasu, Tomasz Nowacki, Hayrapet Kalashyan, Mar Irida Lloret-Villas, Atlantic D'Souza, Sachin Mishra, Jennifer McCombe, Kenneth Butcher, Glen Jickling, Maher Saqqur, Ashfaq Shuaib
Summary: Prehospital triage by MSU of acute stroke syndrome can reliably repatriate patients to the home hospital, providing appropriate medical treatment for patients according to their needs. The proposed model has the potential to triage patients effectively and enable treatment in home hospitals whenever reasonable.
SCIENTIFIC REPORTS
(2021)
Article
Clinical Neurology
Joosup Kim, Damien Easton, Henry Zhao, Skye Coote, Garveeta Sookram, Karen Smith, Michael Stephenson, Stephen Bernard, Mark W. Parsons, Bernard Yan, Patricia M. Desmond, Peter J. Mitchell, Bruce C. Campbell, Geoffrey A. Donnan, Stephen M. Davis, Dominique A. Cadilhac
Summary: The Melbourne Mobile Stroke Unit (MSU) provided prehospital acute stroke treatment including thrombolysis and endovascular thrombectomy. The cost-effectiveness analysis showed that MSU was estimated to cost an additional $30,982 per DALY avoided compared to standard care, but was considered cost-effective due to the earlier provision of reperfusion therapies.
INTERNATIONAL JOURNAL OF STROKE
(2021)
Review
Neuroimaging
Johanna M. Ospel, Adam A. Dmytriw, Robert W. Regenhardt, Aman B. Patel, Joshua A. Hirsch, Martin Kurz, Mayank Goyal, Aravind Ganesh
Summary: Triage is an important process of resource allocation based on their best utilization, need, and potential success. In time-critical conditions like acute ischemic stroke, triage aims to minimize delays and consider factors like resource availability, workflows, and geography. Teamwork is the key factor in optimizing EVT triage, involving various healthcare professionals and requiring continuous efforts and hands-on training.
JOURNAL OF NEUROINTERVENTIONAL SURGERY
(2023)
Review
Medicine, General & Internal
Jieyun Chen, Xiaoying Lin, Risheng Huang, Minyuan Luo, Yali Cai, Wenxiao Zou
Summary: This study aims to compare the effectiveness of prehospital thrombolysis versus in hospital treatment for ischemic stroke patients. Primary outcomes include onset to therapy duration and National Institute Health Stroke Scale scores, while safety assessment will focus on intracerebral hemorrhage and mortality. The findings will be published in a peer-reviewed journal and ethical approval is not required for this review.
Article
Clinical Neurology
Karianne Larsen, Henriette S. Jaeger, Lars H. Tveit, Maren R. Hov, Kjetil Thorsen, Jo Roislien, Volker Solyga, Christian G. Lund, Kristi G. Bache
Summary: This study found that integrating thrombolysis of acute ischemic stroke in an anesthesiologist-based EMS can reduce time-to-treatment and is safe. Mobile stroke units enable prehospital assessment of acute strokes as well as other medical and traumatic emergencies.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Joao Pedro Marto, Alexander Salerno, Errikos Maslias, Dimitris Lambrou, Ashraf Eskandari, Davide Strambo, Patrik Michel
Summary: The study assessed the management of in-stroke-unit ischemic stroke (ISUS) and found that patients with ISUS had more known stroke onset time, fewer missed treatment opportunities, higher endovascular treatment rates, and better long-term outcomes compared to other strokes occurring in the stroke unit.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Public, Environmental & Occupational Health
Marco Piccininni, Tobias Kurth, Heinrich J. Audebert, Jessica L. Rohmann
Summary: The B_PROUD study aimed to evaluate the impact of mobile stroke unit (MSU) dispatch on ischemic stroke and transient ischemic attack (TIA) patients. However, a large proportion of patients did not receive MSU care despite being dispatched. The study found that receiving additional MSU care was associated with better functional outcomes compared to conventional care.
Article
Environmental Sciences
Aaron A. Forbis-Stokes, Arumugam Kalimuthu, Janani Ravindran, Marc A. Deshusses
Summary: A mobile septage treatment unit was built in India and evaluated for operational and treatment performance in the field, processing a total of 273 m³ of septage in two phases with high removal efficiencies after improvements were made.
JOURNAL OF ENVIRONMENTAL MANAGEMENT
(2021)
Article
Clinical Neurology
Alexandra L. Czap, Mersedeh Bahr-Hosseini, Noopur Singh, Jose-Miguel Yamal, May Nour, Stephanie Parker, Youngran Kim, Lucas Restrepo, Rania Abdelkhaleq, Sergio Salazar-Marioni, Kenny Phan, Ritvij Bowry, Suja S. Rajan, James C. Grotta, Jeffrey L. Saver, Luca Giancardo, Sunil A. Sheth
Summary: This study evaluated the performance of a machine learning model in predicting large vessel occlusion in stroke patients on Mobile Stroke Units and found that it performed well in accurately and rapidly identifying LVO in prehospital CT angiograms.
Article
Clinical Neurology
Jessica L. L. Rohmann, Marco Piccininni, Martin Ebinger, Matthias Wendt, Joachim E. E. Weber, Eugen Schwabauer, Frederik Geisler, Erik Freitag, Peter Harmel, Irina Lorenz-Meyer, Ira Rohrpasser-Napierkowski, Christian H. H. Nolte, Darius G. G. Nabavi, Ingo Schmehl, Axel Ekkernkamp, Matthias Endres, Heinrich J. J. Audebert
Summary: This study used data from the B_PROUD study in Berlin to examine the effect of additional mobile stroke unit (MSU) dispatch on functional outcomes among all stroke patients. The results showed that MSU dispatch was associated with improved 3-month functional outcomes, without any significant association with the primary disability scale or 7-day mortality.
ANNALS OF NEUROLOGY
(2023)
Article
Behavioral Sciences
Bo Zheng, Yan Li, Gangfeng Gu, Jian Yang, Junyao Jiang, Zhao Chen, Yang Fan, Sheng Wang, Han Pei, Jian Wang
Summary: This study compared the functional outcomes of acute ischemic stroke patients receiving care from a 5G mobile stroke unit (MSU) and traditional emergency medical service (EMS), and found that 5G MSU care reduces the time from symptom onset to stroke diagnosis and thrombolysis, resulting in improved functional outcomes for patients.
BRAIN AND BEHAVIOR
(2023)
Article
Clinical Neurology
Fadi Al Saiegh, Lohit Velagapudi, Omaditya Khanna, Michael P. Baldassari, Nikolaos Mouchtouris, Karim Hafazalla, John Roussis, Maureen DePrince, Stavropoula Tjoumakaris, M. Reid Gooch, Nabeel Herial, Robert H. Rosenwasser, Pascal Jabbour
Summary: This study demonstrates the efficacy of mobile stroke units (MSUs) in reducing door-to-puncture time and improving the discharge modified Rankin Scale score. Further research is needed to evaluate the cost-effectiveness and optimal protocol for MSUs in stroke care.
WORLD NEUROSURGERY
(2022)
Article
Medicine, General & Internal
Xia Wang, Cheryl Carcel, Benjumin Hsu, Sultana Shajahan, Matthew Miller, Sanne Peters, Deborah A. Randall, Alys Havard, Julie Redfern, Craig S. Anderson, Louisa Jorm, Mark Woodward
Summary: This study found sex differences in pre-hospital management by emergency medical services of women and men admitted to hospital with stroke. Women were more likely to be transported by ambulance, but had similar time to admission as men. Women were more likely to be assessed for conditions other than stroke, such as migraine or anxiety, and were less likely to be managed according to pre-hospital stroke care protocols.
MEDICAL JOURNAL OF AUSTRALIA
(2022)
