Cleveland -- The Cleveland Clinic is trying a new approach to reducing the crucial minutes that pass between when a person has a stroke and when treatment begins.
This summer, the medical center will launch a mobile stroke unit, a $1 million, high-tech vehicle that will respond to 911 calls about suspected strokes. The unit will be equipped with the technology used to diagnose strokes and the drugs that treat the vast majority of the condition.
"We're essentially bringing the emergency room to the patient," Dr. Peter Rasmussen, director of the clinic's Cerebrovascular Center, told The Plain Dealer.
Most of the 795,000 strokes in the U.S. every year are ischemic -- caused by a clot that blocks blood flow, starving brain cells.
The drug TPA can dissolve those clots and reduce disability but only if it's received within three to four hours of the first symptoms, and the sooner the better. Yet only about 5 percent of patients receive it, in part because many stroke sufferers don't get to the hospital in time for testing to tell if they're a candidate.
Rasmussen said the clinic has been working for years to cut down the time it takes to deliver TPA to ischemic stroke patients and get the drug to as many appropriate stroke patients as possible, with limited success.
Last year, clinic staff visited Berlin, where the city's teaching hospital began using a mobile stroke unit to treat patients within a clinical trial setting and reported cutting down the time it takes to deliver TPA to patients by 30 minutes.
In February, the University of Texas Health Science Center announced what it said was the first mobile stroke unit in the U.S. as part of a pilot program testing its effectiveness.
The Cleveland Clinic and the city of Cleveland also will be gathering data about how the new mobile unit impacts stroke patients.
Patients in the city of Cleveland will be able to have a CT scan, receive a diagnosis from a clinic neurologist via a broadband telemedicine link, get blood tests and start treatment with TPA if needed.
The $1 million unit was built by Alabama-based ambulance manufacturer with a donation from the Maltz Family Foundation of the Jewish Federation of Cleveland. It should cost about $1 million a year to staff it with a critical care nurse, a CT technologist, a paramedic and an emergency medical technician.
Though that's not cheap, Rasmussen said most of the cost of caring for stroke patients occurs after hospitalization when patients enter rehab, long-term care or skilled nursing facilities.
He said preventing significant damage from a stroke has the potential to cut down on those costs and that diagnosing a patient in the unit will help direct them to the proper stroke center, cutting down on costly hospital transfers.
The mobile unit is expected to launch in July.
Information from: The Plain Dealer, http://www.cleveland.com