S Regan Cooley1, Henry Zhao1,2, Bruce C V Campbell1,2, Leonid Churilov1,3, Skye Coote1, Damien Easton1, Francesca Langenberg1,4, Michael Stephenson2, Bernard Yan1, Patricia M Desmond4, Peter J Mitchell4, Mark W Parsons1, Geoffrey A Donnan1, Stephen M Davis1, Nawaf Yassi1,5. 1. Departments of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital (S.R.C., H.Z., B.C.V.C., L.C., S.C., D.E., F.L., B.Y., M.W.P., G.A.D., S.M.D., N.Y.), University of Melbourne, Australia. 2. Ambulance Victoria. Australia (H.Z., B.C.V.C., M.S.). 3. Department of Medicine, Austin Health, Melbourne Medical School (L.C.), University of Melbourne, Australia. 4. Department of Radiology, Royal Melbourne Hospital (F.L., P.M.D., P.J.M.), University of Melbourne, Australia. 5. Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Australia (N.Y.).
Abstract
Background and Purpose: Mobile stroke units (MSUs) improve reperfusion therapy times in acute ischemic stroke (AIS). However, prehospital management options for intracerebral hemorrhage (ICH) are less established. We describe the initial Melbourne MSU experience in ICH. Methods: Consecutive patients with ICH and AIS treated by the Melbourne MSU were included. We describe demographics, proportions of patients receiving specific therapies, and bypass to comprehensive/neurosurgical centers. We also compare operational time metrics between patients with MSU-ICH and MSU-AIS. Results: During a 2-year period, the Melbourne MSU managed 49 patients with ICH, mean (SD) age 74 (12) years, median (interquartile range) National Institutes of Health Stroke Scale 17 (12–20). Intravenous antihypertensives were the commonest treatment provided (46.9%). Bypass of a primary center to a comprehensive center with neurosurgical expertise occurred in 32.7% of patients with MSU-ICH compared with 20.5% of patients with MSU-AIS. Compared with patients with MSU-AIS, patients with MSU-ICH had faster onset-to-emergency-call, and onset-to-scene-arrival times at the median and 75th percentiles. Conclusions: MSUs can facilitate ultra-early ICH diagnosis, management, and triage.
Background and Purpose: Mobile stroke units (MSUs) improve reperfusion therapy times in acute ischemic stroke (AIS). However, prehospital management options for intracerebral hemorrhage (ICH) are less established. We describe the initial Melbourne MSU experience in ICH. Methods: Consecutive patients with ICH and AIS treated by the Melbourne MSU were included. We describe demographics, proportions of patients receiving specific therapies, and bypass to comprehensive/neurosurgical centers. We also compare operational time metrics between patients with MSU-ICH and MSU-AIS. Results: During a 2-year period, the Melbourne MSU managed 49 patients with ICH, mean (SD) age 74 (12) years, median (interquartile range) National Institutes of Health Stroke Scale 17 (12–20). Intravenous antihypertensives were the commonest treatment provided (46.9%). Bypass of a primary center to a comprehensive center with neurosurgical expertise occurred in 32.7% of patients with MSU-ICH compared with 20.5% of patients with MSU-AIS. Compared with patients with MSU-AIS, patients with MSU-ICH had faster onset-to-emergency-call, and onset-to-scene-arrival times at the median and 75th percentiles. Conclusions: MSUs can facilitate ultra-early ICH diagnosis, management, and triage.
Authors: Praveen Hariharan; Muhammad Bilal Tariq; James C Grotta; Alexandra L Czap Journal: Curr Neurol Neurosci Rep Date: 2022-02-07 Impact factor: 5.081
Authors: Andrew Bivard; Henry Zhao; Skye Coote; Bruce Campbell; Leonid Churilov; Nawaf Yassi; Bernard Yan; Michael Valente; Angelos Sharobeam; Anna Balabanski; Angela Dos Santos; Felix Ng; Francesca Langenberg; Michael Stephenson; Karen Smith; Steve Bernard; Vincent Thijs; Geoffrey Cloud; Philip Choi; Henry Ma; Tissa Wijeratne; Chushuang Chen; Liudmyla Olenko; Stephen M Davis; Geoffrey A Donnan; Mark Parsons Journal: BMJ Open Date: 2022-04-29 Impact factor: 3.006
Authors: Geoffrey A Donnan; Stephen M Davis; Nawaf Yassi; Henry Zhao; Leonid Churilov; Bruce C V Campbell; Teddy Wu; Henry Ma; Andrew Cheung; Timothy Kleinig; Helen Brown; Philip Choi; Jiann-Shing Jeng; Annemarei Ranta; Hao-Kuang Wang; Geoffrey C Cloud; Rohan Grimley; Darshan Shah; Neil Spratt; Der-Yang Cho; Karim Mahawish; Lauren Sanders; John Worthington; Ben Clissold; Atte Meretoja; Vignan Yogendrakumar; Mai Duy Ton; Duc Phuc Dang; Nguyen Thai My Phuong; Huy-Thang Nguyen; Chung Y Hsu; Gagan Sharma; Peter J Mitchell; Bernard Yan; Mark W Parsons; Christopher Levi Journal: Stroke Vasc Neurol Date: 2021-11-30