With clock ticking, SBU’s Mobile Stroke Unit gears up

Away team: David Fiorella (left), co-director of the Stony Brook University Cerebrovascular and Stroke Center, and Eric Niegelberg, director of the Renaissance School Emergency Department, are the driving force of the Mobile Stroke Unit.
By GREGORY ZELLER //

Fueled by a flood of dire statistics, powered by cutting-edge science and a ready team of medical professionals, the Renaissance School of Medicine’s Mobile Stroke Units are set to roll.

Stony Brook University’s freshly reminted medical school will deploy its first MSU in March – the specially equipped ambulance will carry state-of-the-art CT scanners, telemedicine hookups with expert neurologists and a full complement of medics and nurses – with a second to follow in April.

The units will be “strategically based” at Long Island Expressway exits 57 and 68, SBU said this week, and will operate seven days a week from 8 a.m. to 8 p.m. Each unit will respond to calls within 10 miles of its base and shoot for a response time of “20 minutes or less,” the university added.

Neither the patrol radius or the response time are arbitrary. A 10-mile zone may sound limiting, but the need here is speed, according to David Fiorella, director of the Stony Brook Cerebrovascular & Comprehensive Stroke Center, who calls stroke “the most time-sensitive diagnosis we have in medicine.”

“When a blood vessel supplying the brain is blocked, it is estimated that nearly two million brain cells are lost for each minute that passes,” said Fiorella, also a professor of neurological surgery and radiology at the Renaissance School of Medicine. “The faster we can restore blood flow to the brain, the more likely that the patient will have a full recovery.”

Kenneth Kaushansky: The clock is ticking for stroke victims.

The SBU Cerebrovascular and Stroke Center collaborated with the Renaissance School’s Department of Emergency Services on the MSU program, which is designed to speed what is essentially a stroke-centered emergency room directly to the patient. Each unit will carry a critical-care nurse, a paramedic, an emergency medical technician and a CAT scan technologist, as well as vehicle operators.

At their disposal: CT scanners that can perform standard head CT scans and CT scan angiograms, allowing providers to check immediately for bleeding in the brain and locate leaking blood vessels.

The mobile units also boast telemedicine systems that let emergency-room physicians and neurologists examine the patient remotely, giving the on-site team the best real-time chance to treat ischemic and hemorrhagic stroke.

“We can triage and treat stroke in the field,” Fiorella noted. “We will be able to administer IV [blood-clot medication]. We can then immediately transport these patients to the closest appropriate care facility, where physicians will be waiting to initiate further care.

“These capabilities will significantly reduce the treatment times for stroke,” he added. “For patients with stroke, saving time saves brain.”

The mobile units roll out under the shadow of several frightening statistics from the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention. According to the division, stroke is the fifth-leading cause of death in the United States and responsible for one out of every 20 deaths more than 140,000 U.S. deaths annually.

All told, roughly 795,000 Americans suffer a stroke each year, running up some $34 billion in immediate and long-term medical expenses, according to the CDC.

Renaissance School of Medicine Dean Kenneth Kaushansky, who doubles as SBU’s senior vice president for health sciences, trumpeted “cutting-edge medicine” now improved by critical mobility. New medications and interventional therapies have proven “quite successful” for certain kinds of stroke, according to the dean, “but these treatments are only effective if given very soon after the stroke begins.”

“The Mobile Stroke Unit will greatly improve the chances of a good outcome for stroke patients in Suffolk County by identifying the type of stroke and allowing the immediate administration of the appropriate medications,” Kaushansky added.