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Lifesaving Care 53 Minutes Sooner

Quick Action Changes Outcome

When it comes to stroke, every minute counts. So when Kevin Loughney exhibited signs of a stroke, the actions of a quick-thinking co-worker and the Northwestern Medicine Central DuPage Hospital Mobile Stroke Unit may have saved his life.

An employee at a cybersecurity firm in Geneva, Illinois, Kevin was in the middle of leaving a message to a client when he noticed his speech sounded garbled and incoherent. Deciding his blood sugar was low, he went to get an iced tea. “It was weird. At that point my balance was off, and I was struggling to find words,” says Kevin.

Fortunately, a co-worker immediately recognized the stroke symptoms and made a decision that would change Kevin’s outcome entirely. She called 911 and told the dispatcher that Kevin was having a stroke. The dispatcher then mobilized the Northwestern Medicine Mobile Stroke Unit — the first of its kind in Illinois, and one of the largest in the nation.

The Northwestern Medicine Mobile Stroke Unit is a specialized ambulance equipped with a 16-slice CT scanner to take detailed images of the brain, a direct telemedicine connection to neurologists at Northwestern Medicine Central DuPage Hospital, and stroke-specific medications, including the blood clot-busting drug tissue plasminogen activator (tPA).

“We are essentially bringing the hospital to the patient,” says Mehr Mohajer-Esfahani, MSN, RN, program manager, Northwestern Medicine Mobile Stroke Unit.

Quick Response and Treatment

As a result of his co-worker’s actions, within 30 minutes of first experiencing stroke symptoms, Kevin had a CT scan in the Mobile Stroke Unit to confirm a stroke and received critical treatment with tPA. Being able to diagnose and treat stroke on-site minimized damage to Kevin’s brain.

“I threw up my hands and insisted I was fine. They ignored me and, at that point, I was going along for the ride,” he says. It was only when Kevin was admitted to Central DuPage Hospital that he understood how serious the situation was.

Still in disbelief, he says, “I’m 44, not overweight, no family history. I try to stay in good health. I walked out of the hospital four days later asking, ‘What just happened?’”

Every Minute Counts

Stroke is the leading cause of disability and the fifth-leading cause of death in the United States. During an acute stroke, blood flow to the brain stops. For every minute that passes without oxygen, another 1.9 million neurons in the brain die.

Currently, tPA is the gold standard for the treatment of ischemic strokes caused by a clot. However, it can’t be given until a CT scan or other imaging can determine if the stroke is ischemic or hemorrhagic. The Mobile Stroke Unit allows clinicians to make that determination on the spot, from the patient’s driveway, parking lots or pre-approved sites.

During its first year of service, the Northwestern Medicine Mobile Stroke Unit, which is directly dispatched by 911, provided life-saving treatment an average of 30 minutes faster than traditional transport. On average, the Mobile Stroke Unit delivered tPA to patients following ischemic stroke 52 minutes after 911 dispatch, compared to an average of 82 minutes for patients transported via ambulance. Because of the quick response of Kevin’s colleague, he received tPA only 29 minutes after his symptoms first appeared.

“Every minute the brain goes without oxygen, there is a 3.1-week acceleration of the natural aging process,” said Harish Shownkeen, MD, medical director of the Stroke and Neurointerventional Surgery Programs at Central DuPage Hospital. “By treating stroke patients faster, we are greatly improving the odds patients will suffer minimal to no long-term deficits.”

The Mobile Stroke Unit will respond if a patient or bystander from the service area reports stroke-like symptoms. Service areas include Carol Stream, Glen Ellyn, Roselle, West Chicago, Wheaton, Winfield, Batavia, Geneva, St. Charles, North Aurora, Elburn, Fox River Countryside and Fermi Lab. An ambulance from the local EMS agency and the Mobile Stroke Unit will both proceed to the scene, where they will conduct their assessment. If a stroke seems likely, care is then taken over by the Mobile Stroke Team.

Kevin’s Quest to Help Others

A father of three young boys, Kevin immediately jumped back into his routine. “It happened, and you just have to move forward,” he says.

As fate would have it, Kevin’s neighbor was among those who helped make the Mobile Stroke Unit a reality. “What are the chances I happened to be five minutes away from one of only two in the state, and 20 in the country?” The unit may have saved his life and, now, Kevin is on a quest to help inform others.

His main advice? Know the symptoms of stroke, and don’t be afraid to ask for help.

–  Photo by Sandy Bressner, courtesy the Kane County Chronicle and Shaw Media