Suffolk County residents will soon have one more reason to look to Stony Brook Medicine for the highest level of care for both ischemic stroke (when a clot blocks the flow of blood to the brain) and hemorrhagic stroke (bleeding within the brain tissue).
In March 2019, Stony Brook Medicine will launch Long Island’s first two mobile stroke units. These state-of-the-art units are designed to provide specialized, life-saving care to people within the critical moments of stroke before they even get to the hospital. While new to Long Island, mobile stroke units have successfully reduced stroke disability and have improved survival rates in other major metropolitan areas across the country.
“Time is brain”
Perhaps you’ve heard the expression, “Time is brain.” It’s a reminder that when you have a stroke and the brain cannot get the blood and oxygen it needs, brain cells die. To put this in perspective, it’s estimated that when a blood vessel supplying the brain is blocked, nearly two million brain cells are lost for each minute that passes, making stroke the most time-sensitive diagnosis in medicine. The faster blood flow can be restored to the brain, the more likely that a person will have a full recovery.
Essentially a mobile ER with telehealth capability
Each mobile stroke unit is essentially a mobile stroke emergency room (ER) with telehealth capability to Stony Brook University Hospital. This will allow Stony Brook Medicine physicians at the hospital to determine if a person has a blocked vessel or bleeding in the brain. Once that is determined, the stroke first responders onboard the mobile stroke unit can begin administering time-sensitive, advanced stroke treatments while the person is en route to the nearest hospital that can provide them with the appropriate level of care.
Each Stony Brook Medicine mobile stroke unit will be staffed with:
- A crew of stroke first responders, including a critical care nurse, paramedic, emergency medical technician (EMT) and computed tomography (CT) technologist.
- Medications, including the clot busting agent tPA, which, when administered intravenously, is known as IV tPA.
- Brain imaging equipment, including a CT scanner that can perform both a standard head CT scan as well as a CT scan angiogram. These scans allow doctors to immediately check for bleeding in the brain and determine whether a person has a blocked blood vessel, and immediately initiate treatment with IV tPA (when indicated).
- Stony Brook Medicine Telehealth’s teleradiology and teleneurology services, which enable Stony Brook emergency physicians and neurologists to instantly see and examine a person via video conferencing and advise the mobile stroke unit’s crew en route to the hospital.
More rapid identification of candidates for mechanical thrombectomy
A major new recommendation from the American Heart Association/American Stroke Association is for selected acute ischemic stroke patients to receive mechanical thrombectomy, a procedure to remove clots that block large vessels, as the standard of care. However, an individual must get to a hospital with the physician experts and technology to perform a mechanical thrombectomy early enough to get the most benefit from the treatment.
With the introduction of the mobile stroke units, more people will be candidates for treatment if they are rapidly identified and transported to the Stony Brook Cerebrovascular and Comprehensive Stroke Center early for these time-sensitive interventional therapies.
David Fiorella, MD, PhD, neurointerventionalist and Co-Director of the center, has been performing mechanical thrombectomies for more than 20 years, and has witnessed the remarkable recovery of many individuals who arrived severely disabled and went home from the hospital independent and disability-free.
The mobile stroke units will be available seven days a week, from 8 am to 8 pm, which is the window of time when most stroke calls are received. One will be strategically stationed at the Long Island Expressway’s Exit 57 in Islandia. The other will be stationed at Exit 68 in Shirley. These two locations provide rapid North-South and East-West access. Stony Brook Medicine is working with emergency medical service agencies throughout Suffolk County to coordinate the future dispatching and response of the Stony Brook Medicine mobile stroke units and crew to provide this lifesaving, time-sensitive care to our community.
Stony Brook Mobile Stroke Units in the News
Long Island Hospital to Roll Out Mobile Telestroke Units Next Spring