Kansas City doctor proposes mobile stroke unit for quicker care

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KANSAS CITY, Mo. -- Time lost is brain lost when you're having a stroke. A doctor who directs a major stroke care program at a Kansas City hospital is proposing a way to diagnose and treat patients faster by bringing the E.R. to them.

When a patient comes to the E.R. possibly having a stroke, treatment can't begin right away. CT scans, an exam and blood testing must be done.

"It takes about another 20 to 30 minutes," said Dr. Iftekhar Ahmed of Research Medical Center.

He knows the sooner a patient gets treatment with the drug TPA, the lower the chances of disability and death. That's why Dr. Ahmed wants Kansas City to bring stroke diagnosis and treatment to the patient. It's being done in Houston and Cleveland. Those cities have mobile stroke units. A CT scanner is on board an ambulance. So is blood testing. A doctor makes the diagnosis via telemedicine. Then treatment with TPA can be started on the way to the hospital.

"Of course, that's gonna cut down time drastically." said Dr. Ahmed.

A small study in Cleveland found treatment started an average of 40 minutes sooner.

But a deputy chief for the Kansas City Fire Department, which runs the city's ambulance service, has many questions. How would the city pay for a unit costing more than a million dollars?

"Where are you gonna place these units around the city?" said Tom Collins.

Collins also wonders if patients in Kansas City would get treated faster just being transported by regular ambulance.

"Our transport times are not that long. We're looking at 10 to 15 minutes on average for transport time," he said.

Collins says there's also not evidence yet that the mobile stroke units actually improve outcomes.

But Dr. Ahmed says there's little question that quicker treatment improves outcomes.

"Then you're saving more lives. People are not going to the nursing home and rehab," the neurologist said.

Collins says the city will need to hear more from the medical community about the benefits and logistics before it would proceed with any plan for a mobile stroke unit.