Mischer Neuroscience Institute and UTHealth Medical School Unveil the Nation’s First Mobile Stroke Unit
The Mischer Neuroscience Institute at Memorial Hermann-Texas Medical Center and UTHealth Medical School have unveiled the country’s first mobile stroke unit, made possible by a consortium of partners from the Texas Medical Center, the Houston Fire Department and generous donors.
Onboard the mobile unit is a CT scanner that allows a technician to quickly assess whether a patient is having an ischemic stroke, allowing for the administration of the thrombolytic tPA. “It takes more than an hour once a stroke patient arrives in the emergency room to receive treatment.
So if we can put the emergency room in the ambulance and take the CT scanner to the patient, we can treat the patient at the scene and save over an hour,” says neurologist James C. Grotta, M.D., who is co-principal investigator of a UTHealth trial that will measure cost savings and outcomes. “That hour could mean saving 120 million brain cells.”
Shortly after observing a similar mobile stroke unit in Germany, Dr. Grotta had the opportunity to present his idea to UTHealth Development Board members. He was surprised when a couple approached him and offered to donate a used ambulance.
That couple, John and Janice Griffin, are owners of Frazer Ltd., a third-generation, family-run Houston company that builds emergency vehicles. After looking at the needs of a mobile stroke unit, the Frazer team felt it would need to be engineered from the ground up.
“We really liked the possibilities of moving medicine forward,” says Laura Griffin Richardson, CEO and president of Frazer. “Our company likes to push the limits and this has never been done before. We’re excited to be located in Houston, the forefront of the medical community. Once everyone sees the possibility of putting a CT scanner in an emergency vehicle, the question is, ‘What else can we do?’”
Local businesses also generously supported the stroke unit, giving $1.1 million to UTHealth Medical School, which paid for the scanner and personnel. Operated in conjunction with the call services of the Houston Fire Department, Bellaire Fire Department and West University Fire Department, the mobile unit will be located at The University of Texas Professional Building in the Texas Medical Center. It will respond to calls within a 3-mile radius, transporting patients to comprehensive stroke centers including Memorial Hermann-TMC, Houston Methodist Hospital and St. Luke’s Medical Center. The mobile unit will carry a paramedic, neurologist, nurse and CT technician, and run alternate weeks as part of the clinical trial.
“We know we can speed up treatment but we don’t know how much that speed will affect recovery,” Dr. Grotta says. “We really don’t have data on how receiving tPA within an hour to 80 minutes affects patient outcomes, including the amount of disability. When people have small strokes, they often make a complete recovery on their own. This study will help us determine how much more helpful receiving tPA within 80 minutes is.”
The clinical trial will include the telemedicine program, which is part of UTHealth Medical School and Mischer Neuroscience Institute (MNI). Researchers will investigate whether the telemedicine program, which physicians across the state use to consult with MNI and Medical School stroke experts, can be applied to the mobile stroke unit. If so, the unit potentially could respond to calls using telemedicine, increasing cost-effectiveness.
Elizabeth Noser, M.D., clinical assistant professor of neurology and the James C. Grotta, M.D. Chair in Neurological Recovery and Stroke at UTHealth, is the co-principal investigator alongside Dr. Grotta. Co-investigators from UTHealth and Memorial Hermann-TMC include Tzu-Ching “Teddy” Wu, M.D.; Andrew Barreto, M.D.; and Nicole Gonzales, M.D.
Faculty members from The University of Texas School of Public Health also are part of the collaborative research project. Coinvestigators from the school include Suja Rajan, Ph.D.; Mary S. Baraniuk, Ph.D.; and Barbara Tilley, Ph.D. Stephanie Parker, R.N., B.S.N., is the project manager for the UTHealth Mobile Stroke Unit.
The mobile stroke unit was completed at the end of January; trial runs will be held for one to two months. The study, expected to last three years, began in March.