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Stony Brook Medicine To Deploy Long Island’s First Mobile Stroke Units

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Dr. David Fiorella and Eric Niegelberg
Dr. David Fiorella and Eric Niegelberg

STONY BROOK, NY, December 19, 2018 – The Stony Brook Cerebrovascular and Comprehensive Stroke Center (CVCSC) and the Stony Brook Renaissance School of Medicine Department of Emergency Services will launch Long Island’s first Mobile Stroke Unit (MSU) program to provide residents with immediate, onsite advanced stroke care. The service is expected to deploy its first unit on March 1, with a second to be deployed in April. The MSUs will be available seven days a week, from 8AM to 8PM, which is the window of time when most stroke calls are received. The specially-equipped ambulances will be strategically based at exits 57 and 68 on the LIE, and will take calls within 10 miles of their base, which should ensure response times of 20 minutes or less.

“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, making stroke the most time sensitive diagnosis we have in medicine,” said David Fiorella, MD, PhD, Director of the Stony Brook Cerebrovascular Center and 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.

“With the MSU, we can triage and treat stroke in the field, wherever the call is located. We will be able to administer IV tPA to stroke patients at any remote location. 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. For patients with stroke, saving time saves brain.”

Each state-of-the-art MSU is essentially a “mobile stroke emergency room,” which includes an in-ambulance care team consisting of a critical care nurse, paramedic, EMT and CT technologist, also known as a CAT scan technologist. The units have a telemedicine system that enables Stony Brook emergency physicians and neurologists to see and examine the patient via audio/visual conferencing. The MSUs will provide Suffolk County residents with the highest level of care for ischemic and hemorrhagic stroke.

The ambulance is also equipped with a CT scanner that can perform both a standard head CT scan as well as a CT scan angiogram. These scans will allow doctors to immediately check for bleeding in the brain and determine whether the patient has a blocked or leaking blood vessel. This information will allow the team to initiate treatment with IV tPA (when indicated) and then transport the patient to the nearest hospital that can provide them with the appropriate level of care. These capabilities will dramatically accelerate the delivery of time-sensitive stroke therapies and thereby improve outcomes for patients.

“This is cutting edge medicine,” said Kenneth Kaushansky, MD, Senior Vice President for Health Sciences and Dean of the Renaissance School of Medicine at Stony Brook University. “New, effective medications and interventional therapies have made treating patients with acute stroke quite successful, but these treatments are only effective if given very soon after the stroke begins, and only if given to patients with the right type of stroke. 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.”

Dr. Fiorella and his team perform more than 100 thrombectomies the interventional procedure of removing a blood clot (thrombus) from a blood vessel — a year, a number he feels will grow with the implementation of the MSU program, because more patients will be candidates for treatment if they are rapidly identified and transported to the appropriately certified hospital for these time sensitive interventional therapies.

“We anticipate collaborating with approximately 50 local EMS agencies, based upon a geographic response time from our two units’ base stations,” said Eric Niegelberg, Associate Director of Operations for Emergency Services and Internal Medicine. “Thus far we have overwhelming support from these EMS agencies and we will continue to work with them as the program begins operation. A continuous and ongoing dialogue with our EMS partners is critical for the success of this program.”

In June this year, the Stony Brook CVCSC was certified by the Joint Commission as a Comprehensive Stroke Center the highest level of certification a stroke center can achieve. It is the first and only certified Comprehensive Stroke Center in Suffolk County — the second on Long Island and one of only 11 in New York State. Nationally, less than 200 hospitals out of 5,800 have earned this designation.

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About Stony Brook Cerebrovascular and Comprehensive Stroke Center

Stony Brook Cerebrovascular and Comprehensive Stroke Center (CVCSC) has a dedicated team with the expertise needed to diagnose and treat a wide range of cerebrovascular diseases. Stony Brook Medicine has the first and only certified Comprehensive Stroke Center in Suffolk County. The Center offers a multidisciplinary team of neurologists, neurointerventional surgeons, stroke nurses, and specialized anesthesiologists who are committed to excellence in patient care, research, and education. The CVCSC uses a multidisciplinary, team-based approach, state-of-the-art facilities and equipment, and the latest surgical and minimally invasive techniques to accurately diagnose and treat cerebrovascular disorders. State-of-the-art facilities include high-speed computed tomography (CT), MRI, biplane angiography equipment and a new $14 million cerebrovascular biplane suite. To learn more, visit neuro.stonybrookmedicine.edu.

Stroke Facts

Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention

  • Stroke is the fifth leading cause of death in the United States, killing about 140,000 Americans each year—that’s 1 of every 20 deaths.1
  • A stroke, sometimes called a brain attack, occurs when a clot blocks the blood supply to the brain or when a blood vessel in the brain leaks.
  • Someone in the United States has a stroke every 40 seconds. Every four minutes, someone dies of stroke.2
  • Every year, about 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes; 185,000 are recurrent strokes.2
  • Stroke is an important cause of disability. Stroke reduces mobility in more than half of stroke survivors age 65 and over.2
  • Stroke costs the nation $34 billion annually, including the cost of health care services, medications, and lost productivity.2
  • You can’t control some stroke risk factors, like heredity, age, gender, and ethnicity. Some medical conditions—including high blood pressure, high cholesterol, heart disease, diabetes, overweight or obesity, and previous stroke or transient ischemic attack (TIA)—can also raise your stroke risk. Avoiding smoking and drinking too much alcohol, eating a balanced diet, and getting exercise are all choices you can make to reduce your risk.

Common Stroke Warning Signs and Symptoms

  • Sudden numbness or weakness of the face, arm, or leg — especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance or coordination.
  • Sudden severe headache with no known cause.

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