Mobile stroke ambulance unveiled in Tenn.
The ambulance is designed to save time and combat brain damage in stroke victims; the unit will have a full-sized CT scanner and is equipped for X-rays
By Kevin McKenzie
The Commercial Appeal
MEMPHIS, Tenn. — A new mobile stroke unit unveiled on Tuesday in Memphis is designed to save time, combatting brain damage for stroke victims, by bringing hospital technology and services to their doors.
“We are essentially the equivalent of a stroke center delivered to the doorstep of the patient,” said Dr. Andrei Alexandrov, University of Tennessee Health Science Center neurology professor, chairman of the neurology department and medical director of the stroke ambulance.
The stroke ambulance represents the latest initiative by the UTHSC College of Medicine targeting the major health problems of underserved people in Memphis, said Dr. David Stern, Robert Kaplan Executive Dean and vice chancellor of clinical affairs for the college.
“I want to make a difference in this community and I want the medical school to be a catalyst for change,” Stern said, noting the initiatives could lead to national recognition for the Memphis school.
Memphis, where the stroke rate is 37 percent above the national average, is considered the buckle of the Southeast's stroke belt.
African Americans have twice the risk of having a first stroke and have higher death rates for stroke, which ranks fifth as a leading cause of death but first as the leading cause of disability nationally, according to the American Stroke Association.
The 14-ton stroke ambulance is the first in the world to carry a full-sized CT scanner like those in hospitals and is equipped to x-ray a brain and use dye in blood vessels to pinpoint the stroke-causing clots or ruptures, Alexandrov said.
Doctors or advanced practice nurses staffing the unit can then deliver a damage- limiting treatment known as tPA (tissue plasminogen activator) and the blood pressure drug nicardipine.
“Our goal is from the moment the patient is brought into the ambulance to the moment we can give them the drug, we can do it in 15 to 20 minutes,” Alexandrov said.
The goal of most emergency rooms is to treat 80 percent of stroke patients within 60 minutes after their arrival at the ER, he said. Memphis-area emergency departments, he said, average 45 to 55 minutes. Up to 90 minutes can be saved through eliminated delays in treatment and in emergency rooms.
“Time is brain,” Alexandrov said.
Patients treated on the spot will be able to bypass emergency rooms and be delivered to hospital catheter labs, surgical units, intensive care or stroke units, saving hospital time and resources, he said.
Other mobile stroke units in Europe and in the United States in cities including Houston and Cleveland do not use a fully clinical CT scanner, said Xavier Battle, the Germany-based vice president for product management computer tomography at Siemens AG Healthcare. The German company worked with UTHSC to provide the first one.
“Without any compromise, you can do everything you can do in a hospital right there on wheels,” said Battle, in the audience as the mobile stroke unit rolled onto the floor of the FedExForum.
The Memphis Grizzlies president of business operations, Jason Wexler, is a member of the college of medicine advisory board, providing the link to the unusual location for the unveiling.
A combination of public and private sources have raised $3 million, which will operate the stroke ambulance for three years. With a framework from Canada and custom assembly in New York, Alexandrov said it would cost about $1.3 million to buy it.
“If Donald Trump were here, he would have said, 'It’s huge,' " Alexandrov said.
It will be headquartered at Memphis Fire Department station No. 14, on East McLemore in South Memphis. ZIP codes 38109 and 38106 have the highest incidences of stroke, officials said.
To chart what difference its services will make, beginning in April, the new unit will operate one week and be off the next.
“Hopefully we won’t need too many on-weeks off to demonstrate we can do it faster, safe and with better outcomes,” said Alexandrov, whom Stern recruited in 2014 as one of the college’s faculty members who can make a difference in Memphis.
Stern said Alexandrov also soon will launch a stroke awareness and prevention campaign to help combat strokes in the Memphis region.
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