Abstract Body

Mobile Stroke Units for prehospital acute stroke diagnosis and treatment

Acute stroke can be considered a “major trauma” of the brain and excellent treatments are available to tackle brain damage. But, like in no other disease, management of acute stroke patients is a race against time.

All available therapies are most efficient when administered in the first hours after symptom onset. This is complicated by some of them, like mechanical thrombectomy or neurosurgery, only being performed at highly specialised centres. Moreover, identification of patients benefitting from these treatments needs advanced diagnostic assessments, which are not available at every hospital. All this turns acute stroke into a disease which is difficult to manage.

In this presentation, the concept of a Mobile Stroke Unit (MSU) ambulance shall be introduced. This concept was born in 2003 as a novel strategy, addressing the obstacles to timely patient management.

A MSU is an emergency ambulance equipped with computed tomography (CT) scanners, performing non-contrast brain scans and advanced imaging with CT angiography and perfusion. It also contains a laboratory unit for point-of-care blood analysis and a telemetry connection to the stroke centre.

These ambulances are staffed with highly specialised teams, who diagnose stroke and initiate intravenous thrombolysis at the emergency site, and triage to the required level of care. Evidence demonstrating the benefits on patient outcome when treated on a MSU is growing. Recent trial results emphasise the increase in treatment numbers and reduction of time to acute stroke treatment, leading to an improved clinical result.