Featured Research

from universities, journals, and other organizations

Specialized ambulance improves treatment time for stroke

Date:
April 22, 2014
Source:
The JAMA Network Journals
Summary:
Using an ambulance that included a computed tomography scanner, point-of-care laboratory, telemedicine connection and a specialized prehospital stroke team resulted in decreased time to treatment for ischemic stroke, according to a study. "Our study showed that the ambulance-based thrombolysis was safe, reduced alarm-to-treatment time, and increased thrombolysis rates," the researchers write. "Further studies are needed to assess the effects on clinical outcomes."

Using an ambulance that included a computed tomography (CT) scanner, point-of-care laboratory, telemedicine connection and a specialized prehospital stroke team resulted in decreased time to treatment for ischemic stroke, according to a study in the April 23/30 issue of JAMA, a neurology theme issue.

Stroke is a leading cause of death and disability. In acute ischemic stroke, thrombolysis (dissolving of blood clots) using intravenous tissue plasminogen activator (tPA) is the treatment of choice after excluding bleeding in the brain by imaging. Past studies have shown time-dependent benefits of tPA, with early treatment associated with better outcomes. Apart from delayed patient presentation, management inside and outside of the hospital contributes to treatment delays. Recent data from the United States indicate that less than 30 percent of patients have a door-to-needle time for receiving tPA within the recommended 60 minutes. A recent study reported time-savings for 12 tPA administrations performed in a special ambulance with a CT scanner and laboratory. Little is known about the overall effects of specialized ambulances for treating patients with stroke, according to background information in the article.

Martin Ebinger, M.D., of Charité-Universitätsmedizin Berlin, Germany, and colleagues conducted a study in which a specialized ambulance (Stroke Emergency Mobile [(STEMO]) was randomly assigned weeks when it was available for response in Berlin, which has an established stroke care system with 14 stroke units. The ambulance was equipped with a CT scanner, point-of-care laboratory, and telemedicine connection; a tool to help identify stroke at the dispatcher level; and a specialized prehospital stroke team, which included a neurologist, paramedic, and a radiology technician. If ischemic stroke was confirmed and contraindications excluded, thrombolysis was started before transport to hospital. The overall study population included 6,182 patients.

The researchers found that compared with control weeks, the average alarm-to-treatment (defined as when the dispatcher activated the alarm to tPA administration) time reduction was 25 minutes among patients receiving tPA after STEMO deployment. Also, the rate of tPA treatment in ischemic stroke was higher after STEMO deployment (33 percent) than during control weeks (21 percent).

STEMO deployment was not associated with increased risk for intracerebral hemorrhage or 7-day mortality.

The authors note that the effects found in this study have to be weighed against costs of the STEMO concept. Depending on the configuration of the vehicle, a single STEMO ambulance costs about $1.4 million. Cost-effectiveness analyses are currently under way.

"Our study showed that the ambulance-based thrombolysis was safe, reduced alarm-to-treatment time, and increased thrombolysis rates," the researchers write. "Further studies are needed to assess the effects on clinical outcomes."


Story Source:

The above story is based on materials provided by The JAMA Network Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Martin Ebinger, Benjamin Winter, Matthias Wendt, Joachim E. Weber, Carolin Waldschmidt, Michal Rozanski, Alexander Kunz, Peter Koch, Philipp A. Kellner, Daniel Gierhake, Kersten Villringer, Jochen B. Fiebach, Ulrike Grittner, Andreas Hartmann, Bruno-Marcel Mackert, Matthias Endres, Heinrich J. Audebert. Effect of the Use of Ambulance-Based Thrombolysis on Time to Thrombolysis in Acute Ischemic Stroke. JAMA, 2014; 311 (16): 1622 DOI: 10.1001/jama.2014.2850

Cite This Page:

The JAMA Network Journals. "Specialized ambulance improves treatment time for stroke." ScienceDaily. ScienceDaily, 22 April 2014. <www.sciencedaily.com/releases/2014/04/140422162305.htm>.
The JAMA Network Journals. (2014, April 22). Specialized ambulance improves treatment time for stroke. ScienceDaily. Retrieved October 2, 2014 from www.sciencedaily.com/releases/2014/04/140422162305.htm
The JAMA Network Journals. "Specialized ambulance improves treatment time for stroke." ScienceDaily. www.sciencedaily.com/releases/2014/04/140422162305.htm (accessed October 2, 2014).

Share This



More Mind & Brain News

Thursday, October 2, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pregnancy Spacing Could Have Big Impact On Autism Risks

Pregnancy Spacing Could Have Big Impact On Autism Risks

Newsy (Oct. 1, 2014) — A new study says children born less than one year and more than five years after a sibling can have an increased risk for autism. Video provided by Newsy
Powered by NewsLook.com
Stopping School Violence

Stopping School Violence

Ivanhoe (Oct. 1, 2014) — A trauma doctor steps out of the hospital and into the classroom to teach kids how to calmly solve conflicts, avoiding a trip to the ER. Video provided by Ivanhoe
Powered by NewsLook.com
Pineal Cysts: Debilitating Pain

Pineal Cysts: Debilitating Pain

Ivanhoe (Oct. 1, 2014) — A tiny cyst in the brain that can cause debilitating symptoms like chronic headaches and insomnia, and the doctor who performs the delicate surgery to remove them. Video provided by Ivanhoe
Powered by NewsLook.com
Burning Away Brain Tumors

Burning Away Brain Tumors

Ivanhoe (Oct. 1, 2014) — Doctors are 'cooking' brain tumors. Hear how this new laser-heat procedure cuts down on recovery time. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins