VJVirtual | ESO guidelines on MSUs for prehospital stroke management

Efficient treatments for acute stroke are highly time-sensitive. Therefore, strategies to accelerate the differentiation of stroke patients and optimize access to treatments are needed. The mobile stroke unit (MSU) concept, first introduced in clinical practice in 2008, allows the delivery of stroke diagnosis and treatment directly at the emergency site, contrary to the current practice of awaiting patients to arrive at the hospital. MSUs are ambulances equipped with a CT scanner, point-of-care laboratory, telemedicine connection to hospitals, and are staffed with a stroke specialist team. Silke Walter, MD, Saarland University, Homburg, Germany, and Georgios Tsivgoulis, MD, PhD, MSc, FESO, FEAN, FAAN, National and Kapodistrian University of Athens, Athens, Greece, present the first European Stroke Organisation (ESO) guidelines on MSUs for prehospital stroke management. The guideline was prepared according to ESO standard operating procedures based on the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. The working group provided only one combined recommendation because the exact diagnosis is unclear at the time of the patient’s first contact with the emergency dispatch center. Therefore, they suggest using MSUs over conventional care for the prehospital management of patients with suspected stroke. Two expert consensus statements are also included in the guideline: when considering MSU care specialist neurological expertise and a streamlined process of care are essential, and in confirmed acute intracerebral hemorrhage patients, prehospital management with MSUs is suggested over conventional management because the timely transport of these patients to tertiary stroke centers is crucial for optimal therapeutic management. This interview was recorded during an online conference call with The Video Journal of Neurology (VJNeurology).