Catching it young, to save their death is the goal. To identify stroke at the earliest so that the death of brain cells can be prevented at the earliest is the goal of the Mobile Stroke Treatment Units (MSTUs). These are like highly specialized ambulances, which are specifically suited for stroke patients, so that treatment can be started at the earliest and the patients do not lose out on the ‘golden hour’, ideally the first three hours, window period post the onset of stroke.
When the first symptom of stroke shows, which is something like a sudden dizziness, blurred vision, slurred speech, numbness or weakness and the like, that is when a brain scan can help in determining exactly what happened and determining the course of treatment. The earlier the treatment starts, the better the chances of preventing the death of millions of neurons. More loss of neurons convert to slimmer chances of recovery. So utilizing the golden hour window period is very crucial in stroke treatment. Often this time is lost in commute. By the time the first symptom is noticed in the affected individual, then the caregivers call for an ambulance and then by the time the ambulance brings the patient to the hospital, millions of neurons are already damaged. So the only way to prevent that is to take mobile care to the doorstep and the solution is the MSTU, which comes equipped with the required technology needed to deal with stroke affected patients.
It has a CT scanner, which is used for a brain scan and it is crucial in understanding the exact extent to which the stroke has affected or rather is affecting the patient. The MSTU also has a two-way communication system, so that a neurologist sitting in the hospital can diagnose and determine the result of the CT scan and prescribe the treatment option. They can determine whether it is an ischemic stroke, which is caused by a blood clot, or a hemorrhagic stroke, which is caused by a ruptured blood vessel. If it is found to be an ischemic stroke, which accounts for the majority of stroke cases, then the doctor decides on the dosage of blood-clot busting thrombolytic drugs. The faster these drugs are administered, the lesser the impact of stroke. The presence of an ICU or emergency care nurse in the MSTU is also mandatory, as they are the ones who have experience and understanding of dealing with such patients in the hospitals. They know exactly how to administer these intravenous tissue plasminogen activator (tPA), in an attempt to break the clot. For if the clot is not broken, then it prevents blood supply to a certain part of the brain and that leads to the death of neurons in that part of the brain.
So far India has only one MSTU and for a country with an incidence rate of around 119-145/ 100,000, this is highly inadequate to cater to its entire population. Increasing the number of MSTUs seems to be a likely solution to decrease the healthcare burden and to tend to a disease that is a major cause of death and disability.