STEMO - Stoke Emergency Mobile
Mobile Stroke Unit with telemedicine equipment
Project
MSUs such as STEMO are a stroke care concept that can reduce the previous latency periods of stroke care by means of specially developed telemedicine solutions and the optimization of care processes.
The central goal is the earliest possible identification and appropriate treatment of patients with acute stroke. The idea of the MSU concept, as well as the STEMO solution, is to move the diagnostic and therapeutic measures from the clinical/inpatient (stroke unit/neurological clinic department) to the prehospital/mobile outpatient area (STEMO vehicle) in advance, thereby gaining important minutes until the treatment/therapy starts or the transfer is completed. For this purpose, the engineers of the STEMO project consortium have created a fully-fledged ambulance with a mobile computer tomography (CT) including teleradiological findings, state-of-the-art laboratory technology, digital treatment documentation and telemedicine network solutions.
Technology
The STEMO care concept embodies state-of-the-art technological and telemedical solutions that meet the strictest standards of emergency services.
The specially trained three-person emergency team is equipped with the modern laboratory technology, teleradiological applications and a mobile CT scanner placed in the mobile treatment room of the STEMO vehicle. The mobile treatment room with the CT scanner is shielded against the emission of X-rays. This protects the emergency team and persons outside from unnecessary radiation exposure.
The success of STEMO is validated not only by the results of the accompanying clinical study PHANTOM-S (Abbreviation: prehospital acute neurological therapy and optimization of medical care in stroke patients), but also by the positive feedback from real emergency operations.
Trials
At the International Stroke Conference 2020 in Los Angeles (USA, California), the Berlin team led by Prof. Dr. med. Heinrich Audebert (Deputy Clinical Director of Neurology at Charité Universitätsmedizin Berlin) presented the results of the clinical study B_PROUD (the Berlin - Pre-hospital Or Usual care Delivery). According to these results, early pre-hospital diagnosis and intervention using MSUs/STEMOs, which are specially equipped with both personnel and technical equipment, leads to significantly fewer deaths and disabilities (26 percent) in acute stroke patients than patients whose treatment begins in a hospital. This is particularly remarkable in light of the fact that Berlin alone, with 83 hospitals (figures 2017, Berlin-Brandenburg hospital plan 2020) and 16 regional and supra-regional stroke units (figures 2016, Berlin hospital plan 2016), can certainly be considered as “very well developed” compared to other regions.
The effects of Mobile Stroke Units on functional outcome after acute cerebral ischemia
Presentation of Prof. Dr. med. Audebert, International Stroke Conference
Functional stroke outcomes after mobile stroke unit deployment – the revised protocol for the Berlin Prehospital Or Usual Delivery of acute stroke care (B_PROUD) part 2 study
Neurological Research and Practice, Clinical trial protocol
The central results of the PHANTOM-S study with more than 7.000 patients show that within 21 months the lysis rate in the Berlin area increased by 50%, whereby the lysis therapy was started directly in the STEMO rescue vehicle thanks to special equipment. As a result, the treatment rate of stroke patients increased from 21 to 31%. In comparison to the conventional care route, stroke patients are also treated 25 minutes faster with STEMO. Thanks to a special dispatch algorithm, the recognition rate for strokes directly from the control center has also increased to 53% (with a hit rate of 60%).
Prehospital thrombolysis in acute stroke: results of the PHANTOM-S pilot study
Effects of Golden Hour Thrombolysis: A Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) Substudy
PubMed.gov, National Library of Medicine
PHANTOM-S: The Pre-Hospital Acute Neurological Therapy and Optimization of Medical Care in Stroke Patients - Study (PHANTOM-S)
ClinicalTrial.gov, PHANTOM-S Study Record Detail
Co-work
The solution has been developed with Charité-Universitätsmedizin Berlin and the Berlin Fire Department by technological leadership of MEYTEC GmbH Informationssysteme. The research and development activities of MEYTEC were funded by the state of Brandenburg.
The deployment and adaptation of the STEMO supply concept is carried out in the close cooperation with the medical experts from the Charité Berlin. The variants of the STEMO solution is currently provided by MEYTEC GmbH Medizinsysteme.
The project was funded by the Ministry of Economic Affairs of Brandenburg and the EU. The responsibility for the content of the publication rests with the author.
Stroke, the world's leading cause of permanent disability, is a major challenge for our healthcare systems, with the resulting and ever-increasing financial expenditures for care and rehabilitation of those affected. The MOBILE-STROKE-UNIT concept represents a sustainable and efficient solution on the way to further optimization of the stroke treatment pathway and stands for an improvement in the condition of those affected after a stroke.
The STROKE-EMERGENCY-MOBILE and other innovative telemedicine solutions are provided by MEYTEC GmbH.
MEYTEC has competences in telemedicine and medical technology resulting from many years of experience in the implementation of telemedicine applications, constant innovative further development of systems and services as well as intensive cooperation with medical practitioners in practice.