We are trying to do a better job educating our patients about the warning signs of stroke, and that if they think they might be having a stroke they should act FAST and call 911 to get to the ER as soon as possible.
However, despite these efforts only 5% of US stroke patients get to the ER in time to receive clot busting therapy to treat their stroke. Furthermore, the quicker the drug is given, the better the outcome, TIME IS BRAIN!
We would like to see patients getting treated within one hour of the onset of their stroke, but because of the time it takes to get to the hospital and get evaluated in the ER this is rarely possible.
A pilot study in Texas is looking at getting stroke therapy administered faster by bringing the ER to the stroke patient.
The project brings a mobile CT scanner and a stroke neurologist (via telemedicine) to the patient in a specially equipped ambulance. The investigators hope to see stroke patients getting treated faster and improved outcomes.
Neurology Update 
Very costly truck and is the physician on duty going to permit the medic to administer TPA? I fully understand the cost of time and and its impact of viable tissue in the brain. Given the incidence of false negative C-T scans I do not see true value of something as specialized and costly as this portable C-T scanner – when treatment is unlikely to be started in the field. Even in rural hospitals C-T is readily available and within 3 hours of most of us. Admittedly, it is a fantastic vehicle. I enjoyed the article.
Great points. Yes, the paramedic gives TPA in the field once they’ve cleared the CT and exam with neurologist via telemedicine. The purpose of this CT is primarily to rule out a bleed before giving TPA. They’re saving the time it takes to drive the patient back to the hospital and get the CT in the ER. The former is obviously more relevant in rural communities – although driving to Monmouth is pretty slow going on summer weekends! The latter is an issue everywhere – ERs are busy places, and it routinely takes 40m to get a CT done and read from when a stroke patient hits the door. Does any of this matter? Absolutely. Although we can give TPA within 3 (or in some cases 4.5hrs) of a stroke, the benefit is so much greater at 1hr than it it is at 2hr or 3hrs (click here for more info) that saving this time really helps.