Pre-Hospital Stroke Care beyond the MSU

Area of Science:

• Neurology
• Emergency Medicine
• Medical Technology

Background:

• Mobile stroke units (MSUs) represent an evidence-based advancement in prehospital stroke care, aligning with international guidelines.
• While MSUs are increasingly adopted, traditional ambulances remain the primary mode of prehospital care globally.
• Emerging technologies offer potential to enhance stroke care beyond the MSU model.

Purpose of the Study:

• To review current evidence on prehospital stroke care, focusing on mobile stroke units (MSUs).
• To explore novel prehospital stroke care modalities and research opportunities, both on and off MSUs.
• To outline future directions for prehospital stroke management and research.

Main Methods:

• Review of existing literature on prehospital stroke care, including mobile stroke units (MSUs).
• Analysis of emerging technologies such as portable diagnostics, telemedicine, and artificial intelligence (AI).
• Assessment of advancements in ultra-early biobanking and point-of-care biomarker detection.

Main Results:

• Mobile stroke units (MSUs) demonstrate positive effects on patient outcomes, driving their wider implementation.
• Advancements in portable technology, telemedicine, and AI hold significant potential to transform prehospital stroke care.
• MSUs facilitate large-scale screening for ultra-early biomarkers, aiding in stroke differentiation.
• Point-of-care biomarker tests could enhance prehospital stroke care outside the MSU framework.
• A multimodal approach combining AI-supported telemedicine, portable devices, and biomarkers is a promising future scenario.

Conclusions:

• Mobile stroke units (MSUs) have revolutionized prehospital stroke care and research.
• Future prehospital stroke care will likely involve a synergistic integration of advanced technologies.
• AI-supported telemedicine, portable diagnostics, and biomarker analysis offer a realistic pathway to improve stroke care in regular ambulances.