UR MEDICINE MOBILE STROKE UNIT
A TEAM EFFORT
Launched in October 2018, UR Medicine’s Mobile Stroke Unit (MSU) is an enhanced ambulance, or an “emergency room on wheels,” that brings lifesaving cerebrovascular care directly to stroke victims throughout the Greater Rochester community. The MSU contains specialized staff, equipment, and medications to diagnose and treat stroke at the patient’s location, transporting the patient to the nearest appropriate hospital, all while initial treatment begins on the ambulance.
UR Medicine’s Mobile Stroke Unit: an emergency room on wheels
Time is brain: treating strokes faster
When two million neurons are lost each minute someone is experiencing a stroke, treatment time becomes a critical factor. The MSU’s mission is to save time by bringing the capabilities of an emergency room with stroke expertise directly to the patient.
The unit is equipped with a portable CT scanner capable of imaging the patient’s brain “in the field.” The CT images are then sent via secure online network to physicians at UR Medicine, who are already connected to the unit via telemedicine equipment, visually assessing the patient and reviewing their symptoms. The physician then incorporates the CT scan findings with the visual exam to determine the type of stroke the patient may be experiencing and the specialized care the patient requires.
Depending on the type of stroke, the team can start treatment immediately through intravenous clot-busting medication to begin stabilizing or reversing the stroke. Meanwhile, the telemedicine physician is able to communicate with the destination hospital to ensure needed resources are ready for the patient prior to arrival at the hospital.
With the added ability to obtain images of brain blood vessels that more specifically identify the blocked vessel causing the stroke (also known as “CT angiography”), the MSU brings the full capabilities of the emergency room to a patient’s driveway. As a result of this technological enhancement, eligible patients can now travel directly from the MSU to the operating room at Strong Memorial Hospital, saving precious time to stroke treatment.
We can’t wait for the patient to come to the emergency room. We have to bring the emergency room to the patient. —
TARUN BHALLA, MD, PHD Chief,
The Mobile Stroke Unit Team
Paramedic and EMT Critical care nurse trained in stroke care
CT technologist Stroke neurologist (remotely via telemedicine)
Stroke by the Numbers
Stroke is a leading cause of disability and the 5th leading cause of death in the US. More than 800,000 Americans suffer a stroke each year, including nearly 3,000 individuals in the Rochester region alone
Each minute a stroke isn’t treated, 1.9 million neurons are lost
Fall 2024 will mark the sixth anniversary of the launching of the Mobile Stroke Unit (MSU) in Rochester, only the 11th community in the country to obtain an MSU and one of the smallest markets to benefit from this technology.
The MSU boasts an average treatment time of 20-25 minutes, compared to the national average of 45 minutes, to transport a stroke patient to an emergency room.
The MSU saves over one hour from symptom onset to IV Thrombolytic (IVT) and close to 45 minutes from 911 call to IVT.
Since its launch, the MSU has responded to almost 1500 calls, and has now established the lowest national door-to-needle time of nine minutes for clot-busting drugs
MSU Provides Faster Stroke Treatment
When It comes to Stroke, Time Is Brain!
Stroke can be caused by either a blocked blood vessel (“ischemic stroke”) or a leaky blood vessel (“hemorrhagic stroke”) in the brain. Depending on the region of the brain affected, symptoms can include difficulty using or understanding language, slurring of speech, weakness or numbness of the arm, face, and/or leg (usually on one side), loss of vision or double vision, headache, and/or loss of consciousness. These symptoms usually occur suddenly without warning.
Mobile Stroke Unit Patient Stories
Mobile Stroke Unit
Mobile Stroke UnitJen’s Story
Mobile Stroke UnitCarlos’s Story
Mobile Stroke UnitShawn’s Story
Mobile Stroke UnitDoug’s Story
Mobile Stroke UnitJoe’s Story
The Mobile Stroke Unit History
The Mobile Stroke Unit (MSU) Serves At-Risk Communities
While stroke is a devastating disease nationwide, African American and Hispanic populations experience even greater stroke risks. The MSU program emphasizes partnerships with our underserved inner city patients so that we can work together to understand and remove barriers to rapid stroke care. UR has received over $1M in grant funds from the Mother Cabrini Health Foundation, facilitating the development of a “Stroke Literacy Coalition,” comprised of the MSU team, Action for a Better Community, Ibero American Action League, and Lifespan of Greater Rochester.
Together, this Coalition embeds health educators to reach underserved inner city elderly, African-American, and Hispanic citizens who experience elevated stroke risk and provides widespread stroke education within local underserved communities, with the goal of emphasizing stroke symptom recognition and the importance of activating “9-1-1” immediately upon stroke symptom onset.
UR Medicine’s Mobile Stroke Unit research shows that patients transported by MSU were more likely than traditional EMS-to-ED transport stroke patients, to live in zip codes with a significantly lower overall SES (Socioeconomic Status) Index.
MSU patients had a higher percentage of households with single parents, higher percentage of individuals below the federal poverty line, higher percentage of unemployed individuals, and higher percentage of adults with less than a 12th grade education. In addition, patients transported by our MSU’s were significantly more female, of Black race, and of Hispanic ethnicity. (Jilal et al, 2024)
Over the past several years, the MSU performance data in Rochester are impressive and confirm the importance of the MSU program in improving the lives of stroke victims in our community.
When the MSU is activated, stroke patients treated on the MSU receive IV Thrombolytic:
60 minutes earlier from the time of symptom onset than patients treated in the ER
45 minutes earlier following EMS dispatch than patients treated in the ER
Within 20 minutes after entering the MSU (compared to 45 minutes after entering the ER)
Furthermore, stroke patients who receive IV thrombolytic within the first hour after symptoms begin (the “golden hour”) typically have much better outcomes.
Only 2% of patients in Rochester emergency rooms vs 31% of patients on the MSU, receive treatment within the crucial “golden hour.”
This expedited treatment translates to improved outcomes for patients treated on the MSU including:
1-2 day shorter length of stay in the hospital
Higher likelihood of being discharged to home and family rather than to rehabilitation centers, nursing homes or palliative care
