Abstract
Background and aims
Hybrid mobile stroke units (h-MSU) are specialised ambulances despatched to patients with conditions extended beyond stroke including other neurological emergencies. They are equipped with a mobile CT scanner as well as with ultrasounds, x-ray, ECG, EEG, complex point-of-care laboratory equipment and can provide advanced neurointensive care including intravenous thrombolysis in pre-hospital settings. Czech MSU team and World Organisation of Neurosonology POCUS FoCUS (point-of-care and focused cardiac ultrasound) working group developed multimodule POCUS programme that can be used in many healthcare settings. One of the modules is MSU-POCUS that combines cardiac, medical, neuro, vascular and interventional modalities.
Methods
Five POCUS modules were combined:
Focused cardiac ultrasound
Medical: lungs, abdominal, urinary tract, DVT
Neuro: transcranial and transorbital sonography
Vascular: transcranial Doppler, carotid, vertebral and temporal arteries, aorta
Interventional: ultrasound guided peripheral and central access
The MSU-POCUS was used during the “Challenging geographical condition: How Hybrid-Mobile Stroke Units can contribute to appropriate treatment times” trial in Czechia in the Zlin-Valmez region from October to December 2023.
Results
H-MSU was dispatched to a total of 54 calls, treated 46, six of them received intravenous thrombolysis (with median arrival to needle time of 30 minutes, 17 – 36 minutes) and one patient was transferred to the CSC following CTA detected LVO. MSU-POCUS was performed in nine patients: FoCUS (2), lungs (2), urinary tract (1), carotid (5), peripheral line (4).
Conclusions
MSU-POCUS used in h-MSU’s in pre-hospital emergency care settings is a feasible, safe, rapid and efficient tool adding multiple useful modalities to standard care.
Conflict of interest
Radim Licenik: nothing to disclose