NewYork-Presbyterian, in collaboration with Weill Cornell Medicine, Columbia University Irving Medical Center and the Fire Department of New York (FDNY), is expanding its fleet of Mobile Stroke Treatment Units (MSTU) to Queens and Brooklyn. Thanks to a generous donation by the W.P. Carey Foundation, this makes NewYork-Presbyterian the first health system in the country to operate three of these advanced units. The MSTU is an emergency vehicle equipped to provide immediate, specialized care to patients who may be experiencing a stroke. The unit uses advanced telemedicine technology, allowing neurologists from NewYork-Presbyterian’s hospital locations to be consulted remotely and at a moment’s notice.
Every year, approximately 795,000 people in the United States suffer from a blockage in an artery of the brain, depriving it of blood flow and oxygen, which, over the course of minutes, can lead to disability or death. Stroke is one of the most widespread and debilitating conditions and a leading cause of serious long-term disability in the United States.
On April 30, the New York City 911 System via the FDNY began deploying a unit in the community surrounding NewYork-Presbyterian Queens, an ACS Level 1 Trauma Center and certified Primary Stroke Center by the Joint Commission and by the New York State Department of Health. Beginning May 28, it will deploy a unit in the community surrounding NewYork Presbyterian Brooklyn Methodist Hospital, an ACS Level 2 Trauma Center and certified New York State Department of Health Stroke Center. NewYork-Presbyterian launched the city’s first MSTU – and the first of its kind on the East Coast – in October 2016, serving the communities surrounding NewYork-Presbyterian/Weill Cornell Medical Center at East 68th Street and NewYork-Presbyterian/ Columbia University Irving Medical Center at West 168th Street.
Each MSTU is staffed by a highly specialized team of two NYP paramedics, certified by the Regional Emergency Medical Services Council of New York City, a computed tomography (CT) technologist and a registered nurse. A neurologist is consulted remotely via videoconferencing, an advancement that allows the physician to speak with and view the patient and provide an assessment and recommendations for care. It is designed to significantly reduce the time from the onset of symptoms to the delivery of care, a crucial factor in improving stroke outcomes.
The unit also contains equipment and medications specific to diagnosing and treating strokes, including a medication called tPA, which dissolves the clot and improves blood flow to the part of the brain being deprived of blood in the event of an ischemic stroke. The MSTU also has a portable CT scanner that can image the patient’s brain instantly to detect if the patient is having a stroke. The CT scan is then wirelessly transmitted to a NewYork-Presbyterian neuroradiologist to be promptly evaluated.
During its first year of service, from October 2016 through October 2017, the Manhattan MSTU was deployed 454 times, transported 88 patients and administered tPA 34 times. Since the launch, the MSTU has been able to treat stroke victims approximately 40 minutes faster than a standard ambulance transport.
Once a patient is admitted to the hospital, the MSTU team works to gather pertinent data, including the patient’s outcome after 90 days, the percentage of patients treated by the MSTU who made a full recovery compared with those delivered by standard Emergency Medical Services transport as well as overall cost of care. A larger analysis is currently in progress that will share information from similar units across the United States in order to understand and provide best treatment practices for emergency stroke care.