EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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MOBILE STROKE CARE 34 OCTOBER 2018 | EMSWORLD.com W hile in service for just over a year, Capital Health's Mobile Stroke and Neuro Unit (MSU) has already made a positive impact in the way stroke care is delivered in New Jersey's Mercer County. Spearhead- ing the MSU initiative were Capital Health's Michael Stiefel, MD, director of the Capital Institute for Neurosciences and Stroke and Cerebrovascular Center, and James Boozan, MICP, divisional director of emergency medi- cal services. After speaking with several healthcare systems that had integrated MSUs into their patient care, Stiefel and Boozan began planning their program in the spring of 2016, and with the help of a $2 million grant from the Bristol-Myers Squibb Foundation, they obtained the truck by August of that year. Before diving into the projec t, Boo - zan and Stiefel reached out to the other hospitals in the United States and Europe that utilize MSUs. None of them repor t- ed any significant negatives to dissuade Capital Health from pursuing its own pro- gram. Boozan noted that the New Jersey Depar tment of Health was ver y helpful throughout the planning process. "They were cautious, and I appreciate that because they gave good insight and suggestions about the licensing process," says Boozan. "The Office of Emergency Medical Ser vices was also ver y support- ive. We didn't have any roadblocks." The MSU, manufactured by Frazer, has a CT scanner inside and accommodates point- of- care lab testing. It is staf fed with a CT tech, critical care nurse, and paramedic. The MSU crew welcomes the BLS and ALS crews that are on scene to participate in the patient care process. "You want to be a pit crew [and] work as a well-greased team," Boozan says. " Yo u want to make su re yo u have enough help to stabilize the patient, and that's why it's impor tant for us to work with these agencies," says Boozan, com- menting on the variety of complications a stroke patient can present, like a compro- mised air way, vomiting, combativeness, and altered level of consciousness. "They can obser ve the NIH Stroke Scale being done, and they learn from it—they learn the nuances of what types of presenta- tions strokes give, and they will see the results of the CT scan." The Care Process Upon arrival, if the MSU team suspects a patient is having a stroke, they perform a brain CT scan, which takes about 3–4 min- utes. The crew waits outside the truck. Once the scan is completed, the crew steps back inside and continues caring for the patient while the CT tech transmits the image to LEADING THE PACK IN MOBILE STROKE CARE By Valerie Amato, EMT Photo by Valerie Amato Venturing into new territory in prehospital care may come at a cost, but it may pay o for patients

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