A groundbreaking study has revealed that deploying mobile stroke units (MSUs) across Scotland could reduce emergency department admissions by a staggering 86%. The research, led by a team from the University of Dundee alongside colleagues from England and Germany, analysed patient outcomes when a specialised MSU responded to a 999 call instead of a conventional ambulance.
The Power of Pre-Hospital Diagnosis
The observational study, published in the journal Stroke: Vascular and Interventional Neurology, examined data from 500 patients in the east of England. Half were treated by an MSU crew, while the other half received conventional care. MSUs are essentially ambulances equipped with a CT scanner, a point-of-care laboratory, and advanced communication tools. This technology allows paramedics and remote consultants to diagnose the type of stroke and begin critical treatment at the scene.
Professor Iris Grunwald, chair of neuroradiology at the University of Dundee's School of Medicine and the clinician who introduced the first MSU to England, highlighted the impact. "Time equals brain in instances of stroke," she said. The research showed that this rapid, pre-hospital diagnosis meant 46.4% of patients could be safely managed at home, while 39.6% were transferred directly to a specialist ward, bypassing the overwhelmed emergency department entirely.
Transforming NHS Capacity and Saving Millions
The potential benefits for Scotland's strained health service are profound. With someone in the UK suffering a stroke every five minutes, the societal cost is estimated at £26 billion annually, including £8.6 billion for NHS and social care. Professor Grunwald argued that MSUs offer a clear solution to ease this burden.
"If MSUs were supported and funded across Scotland then the impact on patient flow, hospital capacity and emergency care would be transformative," she stated. The study calculated that even a single MSU could prevent around 600 unnecessary admissions every year, freeing up 3,000–3,600 bed days and saving approximately £1 million annually.
Beyond Stroke: A Multi-Purpose Emergency Resource
Interestingly, the study also demonstrated the versatility of the mobile stroke unit concept. Apart from responding to suspected stroke cases, the MSU was dispatched to emergencies coded for seizures, falls with head trauma, and breathing problems. This suggests that equipping these units with extended capabilities could make them a vital resource for dealing with various emergencies, particularly in remote or non-urban areas.
"This research shows that the MSU concept may benefit from equipping them with extended capabilities," Professor Grunwald noted. For elderly and frail patients, the advantages are particularly significant, leading to safer care, fewer hospital stays, and being directed to the right specialist service immediately. The findings present a compelling case for the widespread adoption of this innovative approach to emergency medical care across the UK.
