- Associated Press - Sunday, October 1, 2017

GLEN ELLYN, Ill. (AP) - On a Saturday morning in March, 47-year-old Cynthia Reid went into her kitchen to make her usual cup of coffee when she dropped to the floor.

“Why can’t I get up?” she wondered.

Reid had suffered a severe stroke in her home near Glen Ellyn. But it could have been far more debilitating, she said, if not for a special ambulance — the first of its kind to roll out in Illinois — and the quick work of a four-person crew from Northwestern Medicine Central DuPage Hospital.

The team examined her, ran a CT scan, sent the images to the hospital, went over the results with an on-call neurologist during a video chat and gave Reid a clot-busting drug that restores blood flow in the brain. All that was done inside the hospital’s mobile stroke unit in about 35 minutes after the rig parked on the street outside her home.

Reid says she owes the team and the ambulance her life. She has recovered her speech and much of the use of the left side of her body, which she initially couldn’t move.

“That thing is a miracle. It really is,” she said. “It has made me be able to live a normal life the best that I can.”

The drug Reid was given, tissue plasminogen activator, or tPA, dissolves clots in the brain for victims of most strokes. The sooner patients receive the medication, the better their prognosis, doctors say.

Since the mobile unit went live in January, patients, on average, receive tPA 54 minutes after the 911 call, said Dr. Harish Shownkeen, the hospital’s medical director for stroke and neurointerventional surgery programs.

By contrast, he said, it takes about 79 minutes from the time of the 911 call until tPA treatment begins in the hospital if that average patient is driven by a conventional ambulance.

And, yes, those 25 minutes can be crucial.

“Every minute your brain is deprived of oxygen and nutrients, more cells die,” said Dr. Stephen Graham, EMS medical director at the Winfield hospital. “You’re just trying to prevent more damage.”

The unit could become part of a new frontier for delivering care outside the hospital.

“With technology moving forward, we’ll be doing even cooler and cooler things on a mobile platform,” Graham said. “It’s just a matter of who decides to push the envelope and who can get it to work well first.”

The ambulance and CT scanner cost about $1 million. The hospital’s foundation provided a grant for both.

It’s stocked with medications and technology that essentially are “bringing the hospital” to the patient, said Mehr Mohajer-Esfahani, the program manager for the mobile stroke unit.

The four-person team — critical care nurse, paramedic, CT technologist and paramedic driver — staffs the ambulance in 12-hour shifts from 8 a.m. to 8 p.m. each day. They respond to patients in Carol Stream, Glen Ellyn, Roselle, West Chicago, Wheaton and Winfield.

The mobile stroke crew is dispatched at the same time as fire department paramedics when the 911 caller suspects someone is having a stroke.

To determine whether a blood clot or a ruptured blood vessel in the brain is causing the stroke, the hospital team prepares the patient for a CT scan, during which the lead-lined ambulance must remain stationary.

“I think the crews have done just a great job of educating people at the scene, whether it’s family, friends or neighbors, that, ‘Hey, the reason the ambulance isn’t leaving is because they’re doing a CAT scan in there,’” Graham said.

With the results, the ambulance nurse makes a three-way video call with the neurologist and radiologist to discuss a treatment plan. The neurologist also can remotely assess the patient.

“They can ask specific questions, interact with the patient, be able to determine if there’s any additional signs or symptoms of a stroke that might have not been caught in the initial exam,” Mohajer-Esfahani said.

There’s another possible advantage to the unit: shorter hospital stays.

“We’ve seen people who have received treatment on board the ambulance spend two to three days in the hospital and then go home afterward versus going to an extended-care facility or rehab facility to get their needs,” Mohajer-Esfahani said.

Other hospitals could soon follow Central Dupage’s groundbreaking example. Rush Oak Park Hospital is waiting for the state to issue a license for its mobile stroke unit. It could be running in as early as the next month or two, a spokeswoman said.

Since January, the Central DuPage unit has made more than 200 runs — a tally that could climb if more people recognize the signs of a stroke and call 911.

“The biggest thing holding it back is people still do not call 911 when they’re having a stroke,” Graham said. “A lot of people wait or they’ll see if they get better, or they say, ‘Well, I’ll just have my family drive me in.’”

Cynthia Reid’s husband, Shane, suspected a stroke when he heard his wife’s slurred speech and saw the left side of her face was drooping the morning of March 25. Paramedics were quickly summoned.

Reid said the mobile unit team kept her calm as they treated her and drove to Central DuPage. She would spend five days in the hospital.

“I am so amazed by that unit and what it does and so glad and lucky that we have it here,” Reid said.

The stay-at-home mom, who has a 10-year-old stepson, attends physical therapy twice a week as she works to regain the full use of her left hand. It’s unclear what caused the stroke, but Reid has quit smoking and adjusted her diet in the hopes of preventing another one.

“Now I try to emphasize to everybody I know, if you have a stroke, call 911,” she said. “Don’t have your spouse take you or your roommate or whatever. You only have a limited amount of time. I’m very grateful to be alive, and I’ve come a long way from where I was five months ago.”


Source: (Arlington Heights) Daily Herald, https://bit.ly/2jcMcVS


Information from: Daily Herald, https://www.dailyherald.com

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