Suffolk County residents now 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 April 2019, Stony Brook Medicine launched Long Island’s first mobile stroke unit program designed to provide specialized, life-saving care to people within the critical moments of stroke before they even get to the hospital. This revolutionary pre-hospital process will markedly accelerate the time to making an accurate stroke diagnosis, allow for time-sensitive stroke therapies to be administered earlier, and allow for the transport of stroke patients directly to the most appropriate hospital for the level of care they require, the first time. The result will be more lives saved, and better outcomes through earlier interventions. 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 one of the most time-sensitive diagnoses in medicine. The faster blood flow can be restored to the brain, the more likely that a person will have a full recovery.
A mobile ER with telehealth capability
Each mobile stroke unit is a mobile stroke emergency room (ER) with telehealth capability to Stony Brook University Hospital. This allows 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 is 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 (which looks at , in detail, blood vessels throughout the body). 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 teleneurology and teleneuroradiology 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.
Improving the chances of a good outcome
The mobile stroke unit program greatly improves the chances of a good outcome because it allows the physicians back at Stony Brook University Hospital to more rapidly identify if someone is a candidate for a mechanical thrombectomy, which is a procedure to remove clots that block large vessels. The American Heart Association/American Stroke Association now recommends for selected acute ischemic stroke patients to receive mechanical thrombectomy 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 unit program, more people will be candidates for treatment if they are rapidly identified and transported to the nearest comprehensive stroke center early for these time-sensitive interventional therapies.
David Fiorella, MD, PhD, neurointerventionalist and Co-Director of the Stony Brook Cerebrovascular 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.
Available at a moment's notice
The mobile stroke unit program is available seven days a week, from 8 am to 8 pm, which is the window of time when most stroke calls are received in Suffolk County. The first mobile stroke unit that was launched in early April is strategically stationed at a base station located off of the Long Island Expressway at Exit 57. A second unit will soon be stationed similarly off of Exit 68. These locations were chosen for easy East West and North South access. The mobile stroke unit team takes calls within a 10-mile radius of each base, which includes about 40 different communities. Stony Brook Medicine is collaborating with over 40 emergency medical service (EMS) agencies throughout Suffolk County to provide this lifesaving, time-sensitive care.
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