E-092 Bringing the treatment to the patient: a single center mobile stroke unit experience. (22nd July 2019) - Shownkeen, H
Abstract : Every minute saved in treatment saves a patient one day of disability (Meretoja et al., 2014). In January 2017, a community hospital implemented a mobile stroke unit to decrease time to treatment and improve outcomes for the surrounding community. The goal of the mobile stroke unit is to treat patients as quickly, safely and efficiently as possible. In comparison to conventional EMS treatment the mobile stroke unit has demonstrated a 31 minute improvement in time to thrombolytic therapy (N=50). Time is measured from alarm to thrombolytic start. An analysis of data from last known well to treatment the mobile stroke unit demonstrates a 42 minute improvement. Treatment in the 'Golden Hour' is especially important as patients treated within 60 minutes of symptom onset have better outcomes. However, less than 1% of patients are treated within the 60 minute timeframe (Ebinger et al., 2015). In the mobile stroke unit, 29% of patients are treated within 60 minutes of symptom onset compared to 7% in the Emergency Department. The goal of improving time to treatment is improving functional outcomes. Sixty-nine percent of mobile stroke unit patients achieve a good or excellent outcome (modified Rankin scale of 0–2). Additionally, 44% of stroke patients treated in the mobile stroke unit return to a pre-stroke baseline compared to 36% in the Emergency Department. There is no increase in mortality rates in the mobile stroke unit group compared to Emergency Department treatment. Symptomatic hemorrhagic transformation rate is 0% compared to 5% in the Emergency Department. In conclusion, the mobile stroke unit has demonstrated a time to treatment benefit. Additionally, there has been an increase in treatment within the 'Golden Hour'. There has been no increase in mortality or complication rates. Disclosures: H. Shownkeen: None. A. Lindstrom: None. H. Crumlett: None. M. Mohajer-Esfahani: None. D. Lumb: None. S. Graham: None.