When Malibu residents call 911 in the case of a stroke, they may now be connected to the UCLA Mobile Stroke Unit for preliminary assistance.
The service officially began in the city on Aug. 27, as confirmed by the City of Malibu.
The unit is the first of its kind in the Western U.S. Though it resembles a traditional ambulance, the mobile unit is additionally equipped with a CT scanner, blood-testing laboratory, live connection with a hospital and stroke medication. The crew includes a neurologist, critical care nurse, CT technologist and paramedic, according to UCLA Health.
The project initially started in late 2017 and was localized to Santa Monica as part of a study to see whether there was a change in the clinical outcome when a patient is treated earlier in the mobile unit versus being treated later at the emergency room. Patients are not obligated to join the study, according to UCLA Arline and Henry Gluck Stroke Rescue Program Medical Director Dr. May Nour, MD, PhD, in a phone call with The Malibu Times.
“This [study consent] does not change their treatment in any way. This unit delivers standard of care clinical treatment for ischemic and hemorrhagic stroke patients,” she wrote in an email.
The stroke unit is in its “demonstration project phase,” the director explained.
“What we do is as we are doing now, monitoring the radios of LA County Fire,” Nour said.
When the unit is available to take a call and is in a decent proximity from the patient, it will go through a “rendezvous process” and meet at a coordinated location. For example, the unit may meet a Malibu patient at an address somewhere along Pacific Coast Highway if that is the best option.
The unit is stationary as the team assesses the patient, essentially—as Nour described it—bringing the hospital to the patient.
She explained that one of the crew’s main tasks is to discern the type of stroke a patient may be having. There are two kinds—ischemic (an artery is blocked by a blood clot) and hemorrhagic (blood vessel is weakened or has burst).
“We have the amenities [similar to] the very first minutes of what being in an ER [emergency room] would be like,” she described.
Nour said a total of 45 patients have been admitted and treated so far, primarily in Santa Monica.
Due to the serious implications of a stroke, the patients would not be taken to a facility like Malibu Urgent Care; patients must be transferred to a certified stroke center for the best immediate care. Nour said, “the greater part of Malibu [is] brought into Santa Monica hospitals.”
Dr. David Frankle with Malibu Urgent Care expressed worries about the program.
“I have reached out to them several times to try and get some insight,” he said in a phone call with The Malibu Times. “... I don’t know that it exists yet. In most things, it’s always about the money.”
It is true that UCLA is working to secure additional funds. The Mobile Stroke Unit team is steadily working to roll out in more areas for a longer period of time with funding from the LA County Board of Supervisors—totalling approximately $1.7 million total—for a 30-month pilot period.
The intent is to have the service available 24/7; currently, the unit is available four days a week (Monday through Thursday) for 10 hours per day, twice a month. The service is available in a few other cities around LA County, including Beverly Hills, Cerritos, Signal Hill, Hawaiian Gardens, La Mirada and Lakewood.
“Our goal is, for this unit, to serve the greatest unit radius within a 10-12 mile radius,” Nour said.
UCLA Health aims to have a second unit in San Mateo County within the next month.
The city does not oversee the program. In an email, city spokesperson Matt Meyerhoff said the service “is an LA County Fire and UCLA Health initiative.”
According to the Centers for Disease Control and Prevention, a person in the U.S. has a stroke every 40 seconds.
When identifying a stroke victim, look for the sudden onset of these symptoms:
- Numbness/weakness in the face, arm or leg—especially if only on one side of the body
- Confusion, difficulty speaking or understanding speech
- Vision trouble
- Trouble with walking, dizziness, balance loss or lack of coordination
- Severe headache
People are also encouraged to utilize “F.A.S.T,” which stands for face, arms, speech and time. First, ask the person to smile and check to see whether one side of their face droops. Next, ask the person to raise both arms and check to see whether one arm drifts downward. Ask the person to repeat a phrase and listen for slurred or abnormal speech.
If the answer is yes to any of these, the CDC advises an immediate 911 call.