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Transforming Early Stroke Care Through Mobile Stroke Treatment Unit Rendezvous With Rural Emergency Medical Services
Nicolle W Davis1, Mahmoud Fayed2, Evan Hardee1
1Department of Nursing and Patient Services, UF Health Shands Hospital, Comprehensive Stroke Center, Gainesville, FL (N.W.D., E.H., D.L., J.M.H., A.E.M.).
Stroke
|January 30, 2025
Summary
Mobile Stroke Treatment Units (MSTUs) significantly reduce stroke treatment times, especially in rural areas through innovative rendezvous protocols. This improves acute stroke care delivery and patient outcomes.
Area of Science:
- Neurology
- Emergency Medicine
- Public Health
Background:
- Mobile Stroke Treatment Units (MSTUs) represent an innovative approach to acute stroke care, extending the "time is brain" principle.
- Most existing MSTUs in the U.S. are located in urban settings, with limited reach into rural communities.
- Florida's first MSTU was launched in Alachua County in July 2023, featuring a novel rendezvous process with rural Emergency Medical Services (EMS).
Purpose of the Study:
- To compare acute stroke outcome metrics between patients treated by an MSTU (including those met via rendezvous) and those treated via the standard EMS-to-Emergency Department (ED) process.
- To evaluate the effectiveness of the MSTU rendezvous process in improving timely stroke care, particularly in underserved rural areas.
Main Methods:
- A retrospective analysis was conducted on acute stroke patients treated between July 25, 2023, and May 31, 2024, at an academic Comprehensive Stroke Center.
- Data included patient demographics and acute stroke metrics, analyzed using univariate and multivariate logistic regression.
- Comparison groups were: MSTU patients (with and without rendezvous) and standard EMS-to-ED patients.
Main Results:
- MSTU patients (with and without rendezvous) exhibited significantly shorter dispatch-to-door, dispatch-to-needle, and dispatch-to-puncture times compared to standard EMS-to-ED patients (P<0.01).
- MSTU rendezvous patients in rural counties showed substantially reduced dispatch-to-door and dispatch-to-needle times compared to EMS-to-ED patients in the same areas (P<0.001).
- These time improvements remained statistically significant after adjusting for age and sex.
Conclusions:
- The study confirms the efficacy of Mobile Stroke Treatment Units in Florida.
- The MSTU rendezvous process demonstrably enhances the speed and efficiency of acute stroke care, particularly benefiting underserved rural populations.
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