Volume : 12, Issue : 11, November – 2025
Title:
PREHOSPITAL MANAGEMENT OF ACUTE STROKE: A SYSTEMATIC REVIEW OF MOBILE STROKE UNITS AND THROMBOLYSIS PROTOCOLS
Authors :
Ahmed Ali Alghamdi, Khalid Ghaeb Almutairi, Maged Brokah Atyre, Ali Hasan Alboainain, Ahmed Mohammed Al Zagaf, Salman Zaal Alshammari, Mokhtar Yousef Albagshi, Saeed Ali Alqahtani, Khaled Madrba Rayani, Dhaidan Fehaid Alshammari
Abstract :
The critical importance of time in acute ischemic stroke management underscores the need for innovative care models. Mobile Stroke Units (MSUs), equipped with CT scanners and point-of-care laboratories, represent a paradigm shift by enabling prehospital diagnosis and thrombolysis. This systematic review aims to synthesize the current evidence on the efficacy, safety, and implementation of MSUs compared to standard emergency medical services (EMS) for acute stroke care. A systematic literature search was conducted across multiple databases (PubMed, Embase, Cochrane, Web of Science) from inception until March 2024. Randomized controlled trials, cohort studies, and systematic reviews comparing MSUs to standard EMS were included. Data on time metrics, functional outcomes, safety events, and protocol details were extracted and synthesized. The review included 18 studies with 12,458 patients. MSU care significantly reduced median alarm-to-treatment time by 31 minutes (95% CI: -38 to -24) and increased the probability of treatment within the golden hour five-fold (RR: 5.25). This translated to a 42% higher likelihood of excellent functional outcome (mRS 0-1) at 90 days (RR: 1.42). Safety profiles were comparable, with no significant differences in symptomatic intracranial hemorrhage or thrombolysis in stroke mimics. Heterogeneity was noted in staffing models and thrombolytic agents used. MSUs significantly reduce time to thrombolysis and improve functional outcomes without increasing complications, establishing a transformative model for prehospital stroke care. Widespread implementation requires standardized protocols and sustainable funding models to maximize their impact on stroke systems of care.
Keywords: Mobile Stroke Unit, Prehospital Thrombolysis, Acute Ischemic Stroke, Emergency Medical Services, Stroke Outcomes
Cite This Article:
Please cite this article in press Ahmed Ali Alghamdi et al., Prehospital Management Of Acute Stroke: A Systematic Review Of Mobile Stroke Units And Thrombolysis Protocols, Indo Am. J. P. Sci, 2025; 12(11).
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