The UCLA Health Mobile Stroke Unit
Stroke continues to be the number one cause of serious disability and the number two cause of death, accounting for 10 percent of all deaths worldwide. In the United States, every 40 seconds someone experiences a stroke and every four minutes someone dies as a result.
Time Lost is Brain Lost: Bringing the Hospital to the Patient
Time has a significant impact on the severity of patient outcomes in stroke. For every passing minute, lack of blood flow to the brain causes two million valuable brain cells to die. The earlier the patient is conclusively diagnosed and receives treatment, the more likely they are to make a meaningful recovery from the devastating effects of the disease.
Early stroke diagnosis and treatment are crucial to achieving clinical recovery in stroke survivors, enabling them to have a better quality of life. In order to expand timely access to emergency care and treatment, UCLA Health, the Los Angeles County Department of Emergency Medical Services (EMS), and the Department of Health Services (DHS), with support from the L.A. County Board of Supervisors, partnered to launch California’s first mobile stroke unit (MSU), now operating in three rotating geographic sites in L.A. County.
Unlike standard ambulance care, the MSU is a specialized ambulance that offers highly advanced clinical care in the prehospital setting. It is staffed by a vascular neurologist, either in person or by telemedicine; a critical care nurse; a firefighter paramedic; and computed tomography (CT) technologist. The MSU offers resources for rapid turnaround laboratory testing as well as CT scan technology, enabling the examination of brain tissue and brain blood vessels in the vehicle prior to arrival at the hospital. After the CT scan demonstrates whether stroke symptoms are caused by vessel blockage and lack of blood flow or, alternatively, bleeding into the tissue of the brain, patients can be quickly treated with brain and lifesaving medications in the MSU and routed to the most appropriate level-of-care stroke center.
Vital Access to Specialized Care: A Groundbreaking Approach
Since its launch in 2017, the program’s clinical operations have greatly expanded, providing more L.A. County residents with access to this highly unique and advanced resource. Through support from the L.A. County Board of Supervisors, the program has increased its partnership from one fire department, serving one city in September of 2017, to six fire departments serving 23 cities in the county in three alternating geographic sites (with coverage in the western, southern and South Bay regions of L.A. County).
Crucial Access Benefitting Our Communities
Given that minority populations in the U.S., including African Americans and Hispanics, have higher rates of stroke incidence and increased rates of disability and death as a result of their disease condition, the UCLA Arline and Henry Gluck Stroke Rescue Program has included in its coverage service to geographic locations of the county that are socioeconomically disadvantaged, have longer transport times to stroke centers, and have a high incidence of stroke volumes. Through its clinical operations, the MSU also contributes to the vital education of first responders on the front line of emergency medical care. The program also educates patients in the region to recognize stroke signs and symptoms and to immediately call 911. The MSU was designated by DHS as a shared regional resource of L.A. County.
Leading-Edge Research Contributing to Future Expansion of MSUs
UCLA Health is participating in a national demonstration project to quantify the clinical benefit and cost-effectiveness of operating MSUs that can provide prompt treatment with clot-busting medications. The study, sponsored by the Patient Centered Outcomes Research Institute will help advance stroke care in the prehospital setting. A second study focused on sophisticated geospatial mapping of stroke occurrences in L.A. County will shed light on the number of MSUs needed to offer care to all Angelenos and their respective location of coverage.
Time Saved is Brain Saved
Accelerating diagnosis and treatment will save brain cells and help reduce the risk of disability following a stroke. The UCLA Health MSU is a key tool in the university’s vision to improve patient outcomes and provide service to the community.
During the challenging times of the COVID-19 pandemic, in which stroke incidence has increased as a result of the disease’s pro-thrombotic/clotting effect, the MSU has been an extremely valuable resource. Aside from diagnosis, treatment, and precise patient routing, patient counseling about the importance of transport to the hospital has been integral in a time when many patients fear calling 911.
UCLA Health anticipates future expansion of clinical services with an ultimate goal of providing care to all of L.A. County by adding 7-10 MSUs. These MSUs also will serve to advance clinical innovations in stroke detection, EMS notification, and the allocation of specialized MSU resources. You can help advance stroke treatment by supporting this groundbreaking approach to rapid stroke care.
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