The STroke Emergency MObile (STEMO), a specialized ambulance vehicle, equipped with a computed tomography (CT) scanner, point of care laboratory devices and staffed with a trained team of specialists in acute stroke care (one neurologist, one paramedic and one radiology assistant) is available for prehospital thrombolysis of patients with acute ischemic stroke in Berlin, Germany.
More information/project description
A new stroke emergency mobile unit "STEMO" was planned and constructed together with the Berlin Fire Brigade, that is responsible for emergency ambulance care in Berlin, and MEYTEC, a leading company for telemedicine equipment. The new ambulance has a portable CT scanner and all necessary point-of-care laboratory equipment on board. The STEMO team consists of a neurologist trained in emergency medicine, a paramedic and a radiology technician. They are linked via telemedicine to the Charité hospital. Via videoconference they are connected to senior stroke neurologists in the Department of Neurology, and via teleradiology they can transmit the CT images for reading by neuroradiologists. Additional potentials of this new mobile facility are an improved triage of stroke patients with delivery to endovascular capable hospitals after diagnostic workup as well as a new platform for innovative therapies in the "golden hour of stroke". During the pilot phase of the project between February and May 2011, STEMO was tested for its technological stability and organizational reliability. Thereafter, its safety and its efficacy in reducing time-to-treatment were evaluated in a large controlled study by comparing weeks with STEMO availability to alternate weeks without it. This study proved that prehospital application of thrombolysis not only shortened time-to-treatment by 25 minutes, but also increased the proportion of patients treated with thrombolysis by 50 %. In addition, more patients were delivered to the most appropriate hospital. In a Berlin-wide study until the end of the year 2019, effects of STEMO availability on functional outcome will be assessed.
During the pilot phase of the project between February and May 2011, STEMO was tested for its technological stability and organizational reliability. Its safety and its efficacy in reducing time-to-treatment were evaluated in a large controlled study by comparing weeks with STEMO availability to alternate weeks without it.
This study proved that prehospital application of thrombolysis not only shortened time-to-treatment by 25 minutes, but also increased the proportion of patients treated with thrombolysis by 50 %. In addition, more patients were delivered to the appropriate hospital. In a Berlin-wide study over the next 3 years, effects of STEMO availability on functional outcome will be assessed.
