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Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

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Published on: January 15, 2017

Pre-Hospital Diagnosis in Mobile Stroke Unit.

Ramnath Santosh Ramanathan¹, Dolora Wisco¹, Daniel Vela-Duarte¹

¹Cerebrovascular Center, Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, S80, Cleveland, OH 44195, United States.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|April 20, 2021

Summary

Mobile stroke units (MSU) treat emergent neurological conditions beyond acute ischemic stroke (AIS). These mobile units effectively manage stroke mimics and intracranial hemorrhages, expanding their pre-hospital treatment capabilities.

Keywords:

Mobile stroke unit Pre-hospital mobile stroke unit diagnosis Stroke Thrombolysis

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Area of Science:

Neurology
Emergency Medicine
Pre-hospital Care

Background:

Mobile stroke units (MSU) are established for rapid pre-hospital thrombolysis in acute ischemic stroke (AIS).
MSUs encounter a range of neurological emergencies beyond AIS requiring immediate intervention.

Purpose of the Study:

To analyze the spectrum of neurological conditions treated by MSUs.
To evaluate the utility of MSUs in managing non-AIS emergent neurological disorders.

Main Methods:

Prospective data collection from 221 consecutive MSU encounters.
Pre-hospital diagnosis using clinical evaluation and neuroimaging on MSU.
Categorization of diagnoses into AIS, intracranial hemorrhage, and stroke mimics.

Main Results:

Approximately one-third of MSU encounters involved conditions other than AIS.
Intracranial hemorrhage accounted for 7% and stroke mimics for 27% of encounters.
Common stroke mimics included metabolic encephalopathy, seizures, and migraines.

Conclusions:

MSUs treat a significant proportion of non-AIS emergent neurological conditions.
The capabilities of MSUs extend to managing intracranial hemorrhage and stroke mimics.
MSUs offer valuable pre-hospital treatment for diverse critical neurological presentations.