Approximately one-third of stroke patients reached by a mobile stroke unit get treated in the first hour after stroke symptoms start, compared with less than 1 percent who are treated at the emergency room, Grotta said.
“It starts with the patient calling 911,” he said. “Recognizing, and not ignoring, the symptoms of a stroke is critical.”
Symptoms can include face drooping, arm weakness and speech difficulty. Approximately 800,000 Americans each year have a stroke, the nation’s fifth-leading cause of death.
The University of California, Los Angeles launched a mobile unit in September after working closely with local government officials to address regulatory issues, said May Nour, M.D., Ph.D., an interventional neurologist and medical director of the UCLA Arline and Henry Gluck Stroke Rescue Program.
Although the benefits and cost-effectiveness must be scientifically proven before there is wider use, Nour hopes to soon have enough mobile units to cover all of Los Angeles County.
“Anything that’s new takes time,” she said. “We are doing the tough task of banding together nationally and internationally to evaluate the evidence.”
A study in The Lancet Neurology in September 2016 did not find statistically better outcomes in pre-hospital treatment versus conventional treatment. But the study, limited by a small number of patients, suggested mobile unit treatment might lead to improved results. Researchers said a large-scale trial is needed.
Grotta’s team is conducting a large randomized trial through PCORI, the Patient-Centered Outcomes Research Institute. Along with Houston, mobile stroke units in Memphis, Tennessee, and Denver, Colorado, are participating to examine patient outcomes during weeks when a mobile unit is dispatched versus other weeks of standard treatment. A separate analysis will look at the costs of implementing a mobile stroke unit versus the cost savings that result from better outcomes for patients.
The price for a mobile stroke unit ranges from $600,000 to $2 million, according to the consortium PRESTO, the PRE-hospital Stroke Treatment Organization. Making a physician available through telemedicine rather than in person can save money in staffing and has been determined to be just as accurate, Grotta said.
Hospitals usually pay for the units through philanthropy because insurance reimbursements don’t cover the startup costs and cover little of the clinical activities performed in the unit, he said, but more research may show clear cost benefits.
Nour believes cost-effectiveness ultimately will be proven with the positive impact on patients’ lives.
“Proving cost-effectiveness will allow this innovative stroke care delivery platform to be accessible to all stroke survivors by changing the infrastructure of prehospital care,” she said. “But we need to show that.”
If you have questions or comments about this story, please email editor@heart.org.
For more information on hospitals utilizing mobile stroke units across the country, click here.
Source
AMERICAN HEART ASSOCIATION NEWS
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http://www.meytec.com/download/datasheets/db-vimed-stemo-en.pdf
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The STEMO concept is developed for optimization of the prehospital stroke care. It shows clear advantages over the standard channel of supply, under conditions of the real rescue operation. VIMED® STEMO is a specially equipped emergency vehicle with comprehensive telemedicine and medical equipment. The full diagnostic and therapeutic measures for acute stroke patients can be immediately initiated locally. For this purpose the STEMO vehicle is equipped with a mobile computer tomography (CT).
All examination measures with the CT-scanner and the patient transport to the next stroke unit happens directly (compared to the other concepts) in the STEMO-emergency vehicle. The radiological DICOM-images are transmitted into the diagnostic location by means of an encrypted VPN-tunnel via fail-safe UMTS and LTE solutions or a satellite. Optionally, the radiological images can also be evaluated directly on the medical findings monitor installed according to the German Radiology Regulation (RöV) locally. Intelligent automatic switching between the available mobile networks provides VIMED® STEMO a high level of independence from the quality of the transmission networks. The STEMO solution is a mobile clinic with multimodal tele-consultation equipment for the complete emergency care of acute patients. Constructed on the strict rules of rescue services the STEMO vehicle is today used under real conditions with real patients in the Berlin area. The patient location could be achieved here on average in 16 minutes to bring the stroke patients within 52 minutes (from the emergency call) to the next stroke unit. All lysable patients receive a treatment initiated directly in the STEMO-vehicle.
Telemedical system for the pre-hospital diagnosis and therapy of acute stroke patients
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhWrNZiIVyd2ckwp8B91wetEe7v1kaSSp5m5WckgjTko22HP6wEFGAxo6sP1BX4SOcg19YvRmJYClYzyXRbUJXUpZX6HMayd5GnIRwlOZrRlDrr-6EUNQ6HBgP5m4lQHoomGsMy_2NlVtM/s640/vimed-stemo.jpg)
STEMO is a principally new stroke care concept, that has closed previous gaps in stroke care practice with the help of specially developed telemedicine solutions and optimization of the care processes. The central objective is to optimize the treatment of acute stroke patients in metropolitan environments, especially for the benefit of the patient. The central idea of STEMO solution is to bring forward the expensive diagnostic and therapeutic measures from the clinical / inpatient (stroke unit / neurology department) in the pre-hospital / mobile-ambulance sector (STEMO vehicle). The engineers of the project consortium STEMO have created a full size emergency vehicle with an integrated mobile computer tomograph (CT), providing teleradiology diagnostics, modern laboratory equipment, electronic treatment documentation and telemedical networking. The overall solution is the result of the collaboration with Charité University Medical Center Berlin, Berlin Fire Department, MEYTEC GmbH Information System and Thermo Fisher Scietific BRAHMS biomarker.
The supply concept STEMO, embodies modern technology and telemedicine solutions that meet the most stringent standards of the rescue service. The success of STEMO is not only confirmed with the results of the associated clinical trial PHANTOM-S (pre-hospital acute neurological therapy and optimization of medical care in stroke patients), but also the positive response from the real emergency missions.
The key results of the PHANTOM-S trial with more than 7.000 enrolled patients show that the lysis rate in the Berlin area has been raised by 50% within the 21 months, while starting the thrombolytic therapy directly in STEMO rescue vehicle with special equipment, the patient is then transported to the appropriate acute center. The treatment rate of stroke patients has been raised from 21 to 31%. Comparing the care of stroke patients in the STEMO supply concept with the supply on the usual supply route, the patients were treated 25 minutes earlier with STEMO. The special rescue algorithm increases the recognition rate of strokes directly from the emergency call center to 53% (hit ratio 60%).
A specially trained three-man team has at their disposal the most advanced laboratory technology, teleradiology applications and a mobile CT scanner in the treatment room of STEMO unit. The mobile treatment room with the CT scanner is shielded from X-rays, so that both the team and the people outside of the mobile treatment room are protected from any radiation.
The use and assimilation of the stroke care concept STEMO, is accompanied by the close cooperation with the experts from the Charité Berlin. Different modifications of the STEMO solution can be directly purchased as VIMED® STEMO from MEYTEC GmbH Medizinsysteme.
18 de marzo del año 2015 La ambulancia especializada STEMO "Tomografo Movil" y TELEMEDICINA choca en las calles de Alemancia
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![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4W37UkPzcuVVcNO-W22NQJvR7rdTzUk1T1O1-4Kv_OF59C9JlMoZ_K-bpJgcoOnA5YLfzVHLWfsyIIYxPq_0eEjfURi3HAOuJHCMGh7umbIweGzuF3ClANkTlO7B_YrKNRV8LOY1DCec/s640/Inside-Stemo-stroke-ambulance-with-CT-scanner-703x437.jpg)
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![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgl3TwSnEsGLWADQH8GRqC5MUFGQl8KIrJ1MrXQqRQupyXFrpDE9ZRo9bfzEmKhwFnS-xay66MK6TRihASliGJ8W7BB1qrKls55H9MKHCC5qowuVnVsCIQqrGPbglcfQKaZ8IG1U2PIrsM/s640/STEMO_2.JPG)
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUiexmbB_tjcyY59Mx5-N3eDWem8Za8Dke8CAjmCsIdlqbKZSJuxwMaOZ2P9dYjhcBbE-zV4JDb7j05zjoyZnbJsw-75pRzsZfwSQIQ69A19XDr7-Dnal82N605k-VO1Z0FePp7JIHCpQ/s640/STEMO_CT.JPG)
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Este tipo de camiones presentan una extraordinaria e innovadora plataforma de tomografía computarizada de haz cónico (CBCT, por sus siglas en inglés) de bajo consumo de energía, de tamaño reducido, dosis bajas y alta resolución.
Estas unidades #radiodiagnósticas destacan por su:
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Programas de salud de detección precoz específica, como exámenes de detección de cáncer de pulmón o evaluaciones de riesgo cardiovascular, que lleguen a una población más amplia.
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