UPPER EAST SIDE — The first few moments after someone has a stroke is the most critical — with 1.9 million brain cells lost for every minute without treatment, experts say.
That's why NewYork-Presbyterian has worked with the FDNY to develop a new ambulance equipped with everything needed to treat stroke patients on the scene. It's the first of its kind in all of the east coast, according to hospital officials.
The Mobile Stroke Unit will be dispatched when anyone calls 911 for stroke symptoms in communities served by NewYork-Presbyterian/Weill Cornell Medical Center at East 68th Street, and New York-Presbyterian/Columbia University Irving Medical Center at West 168th Street.
The unit will be manned by two paramedics, a CT technologist and a neurologist who can diagnose and treat strokes on the spot. Crucial medications will also be on hand, including tPA — a medication that dissolves, improves blood flow to the brain, and must be taken within a four-and-a-half-hour window of first symptoms.
"As it is now, an ambulance will come out, assess you, and take you to the nearest hospital," said Dr. Matthew Fink, the the neurologist-in-chief and chief of the Division of Stroke and Critical Care Neurology. "The doctors there then have to figure out what's going on. All that takes a lot of time. In this case...we have all the equipment and drugs on the ambulance. We make the diagnosis in five minutes and start treatment. The faster you start the treatment, the faster the recovery is going to be."
Roughly 85 percent of strokes that the FDNY responds to are ischemic strokes, or smaller blood clots that typically respond to tPA, according to FDNY officials.
The CT scanner helps the medical team locate the clot and wirelessly transmit the scan to the hospital, where it is seen by a neuroradiologist. It can also help medical staff determine whether the patient needs a different type of treatment and alert the hospital so it can prepare, Fink said.
NewYork-Presbyterian has been involved in the forefront of stroke treatment since the 1980s and takes care of the largest number of stroke victims in New York City (2,000 a year), and has the largest number of good outcomes and results, Fink said.
Most cities in Europe have been devoting mobile units to stroke victims this way for many years and only now is the U.S. catching up, he added.
The mobile unit started taking patients on Oct. 3, and is only serving the communities around its hospitals, but the hope is to add more units in the near future.
The hospitals will also track outcomes and share information with similar units throughout the country for a larger study on best treatment practices.
"This is just the beginning," Fink said. "There will be a number of innovative clinical treatments that we will be developing in the future for the treatment of stroke in the field."