NeuroLogica and MEYTEC from Germany have developed a specialized stroke ambulance, called VIMED STEMO, that carries a portable CT scanner and a point-of-care laboratory for nearly-instant diagnosis and initiation of treatment in stroke patients. It employs MEYTEC’s telemedicine solutions and NeuroLogica’s portable CT scanner, CereTom.
The VIMED STEMO integrates a fully-functioning pre-clinical stroke care suite, comparable to those found in specialized stroke hospitals. The onboard CereTom is a 8-slice CT scanner that allows for multimodal imaging with CT angiography and CT perfusion in combination with a rapid scan time. Imaging and other data can be transmitted over encrypted 3G, 4G and satellite connections to emergency rooms or trauma centers.
In addition to being well-equipped, the ambulance also carries the best medical team you could get delivered to your door when you might be suffering from a stroke, including a paramedic, a stroke physician and a neuroradiologist. All together, this enables hyper-acute stroke care, including thrombolytic treatment as soon as possible, well before arrival at a hospital. No word on how much this all costs per trip.
Of course, the question remains whether this hyperacute care translates in better patient outcomes, but the companies have already conducted a randomized trial that provides some clues. They randomized 100 patients to either the stroke ambulance or usual emergency care. Unsurprisingly, pre-hospital stroke treatment greatly reduced the median time from alarm to therapy decision (35 versus 76 min) with similar gains in times from alarm to end of CT, and alarm to end of laboratory analysis, and to intravenous thrombolysis for eligible ischaemic stroke patients.
There was no substantial difference in neurological outcome between the groups, however the current study was not powered to detect such a difference and follow-up was relatively short. It does show that pre-hospital stroke diagnosis and treatment is feasible and may reduce time-to-treatment to a level that was previously unreachable. The VIMED STEMO is currently embedded in the emergency service system of Berlin.
More info: Project STEMO…