Ohio county to get $1M mobile stroke unit

Mercy Health Foundation is funding the vehicle, which could cut in half the time it takes to diagnose a stroke and begin treatment

By Marlene Harris-Taylor
The Blade

TOLEDO, Ohio — When Lucas County residents call 911 because they think they’re having a stroke, they may soon find an extra emergency medical unit at their front door.

The Mercy Health Foundation has put $1 million toward financing a high-tech mobile stroke unit that could cut in half the time it takes to diagnose a stroke and begin treatment.

“Studies show right now that from the time a call goes into 911 and the patient gets tPA [blood-clot-busting drug] in the hospital setting it’s in the neighborhood of 80 minutes.

“Studies show that with the mobile stroke unit responding, the patient is getting that medication in less than 40 minutes,” said Julie Goins-Whitmore, the nurse who will oversee the 20 nurses, paramedics, and CT technicians who will staff the mobile stroke unit.

The drug tPA is often administered to patients suffering the most common kind of stroke, an ischemic stroke, which means they are not getting enough oxygen to certain parts of their brain, usually becasue of a blood clot. 

The unit also will have the ability to administer the drug Kcentra, which can be used to help thicken the blood if a person is suffering a hemorrhagic stroke, “where they have a big bleeding stroke in their brain,” Ms. Goins-Whitmore said.

When it comes to treating a stroke, minutes count, said Dr. Imran Andrabi, president and chief executive at Mercy.

Stroke is the fourth-leading cause of death in the United States. 

That means someone dies from a stroke every four minutes. 

Stroke is also the No. 1 cause of long-term disability for adults, Dr. Andrabi said.

“Every minute you lose more than a million brain cells. What this enables us to do is to get there sooner, faster, and to start treatment right away and hopefully that translates into people being able to get up and walk and not being in a nursing home for long periods of time,” he said.

Lucas County 911 operators will dispatch the unit, along with the traditional life squads, to scenes with suspected stroke victims. 

The unit has a CT scanner and a lab. 

Test results will be sent to a doctor through a telemedicine device so the doctor can immediately diagnose a stroke and instruct the nurse on board to start medication, Ms. Goins-Whitmore said.

Dr. Eugene Lin, endovascular neurosurgeon, who is the medical director for the stroke unit, will be able to look at the results of the patient’s CT scan and blood work taken in the mobile unit from anywhere through a cell phone or iPad.

“We can be anywhere in the city, in the state, we can even be across the country and still have access to the units to interface with the EMS staff, the crew, and, of course most importantly, the patient,” he said.

Work remains to be done, however, to get the mobile stroke unit, and the network of people needed to staff it, up and running before it is expected to hit the streets in mid-October, Dr. Lin said.

Mercy wants to hire more doctors and the Lucas County 911 call center staff is to undergo training to assess over the phone whether a patient might be having a stroke. 

Dr. Lin and his team plan to work closely with the county on the training that will likely take place in September to ensure the 911 staff is ready for the launch of the stroke unit.

The 911 operators are to assess whether a person is displaying the signs of stroke.

“Traditionally it’s facial droop, a loss of function on one side, and slurred speech,” Ms. Goins-Whitmore said.

“Our aim is to go for a 24-7 model and we’ll fine tune that and staff it appropriately to make sure that even at different hours they get the same benefit,” Dr. Lin said.

There is only one mobile unit and it has yet to be determined where it will be housed, Ms. Goins-Whitmore said.

There will be times that it would not be feasible to dispatch it depending on how far the stroke victim is from the unit.

“It won’t make sense for us to respond if we are in East Toledo to Sylvania because the patient could get to a stroke center first. So we would not want anybody to delay care until this unit arrives,” she said.


©2015 The Blade (Toledo, Ohio)

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