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Central DuPage's mobile unit will treat strokes on the road

Joe Carrabba says there are two reasons he's alive today: divine intervention and the mobile stroke unit of University of Texas Health Science Center at Houston.

Carrabba, then 60, had a severe stroke in 2015 at his Houston home. An ambulance started driving him to a hospital, but a mobile stroke unit intervened on the way. Carrabba was transferred into the unit at a gas station off the highway.

In a matter of minutes, he was examined by a doctor, underwent a CT scan, was assessed by a neurologist via videochat and was administered a clot-busting drug to restore blood flow — all actions that previously could take place only at a hospital.

Just three days later, Carrabba walked out of medical center with no neurological deficits. In other cases like his, patients often face lengthy hospital stays and extensive rehab, or even death.

“It's a lifesaver,” Carrabba said. “How bad the stroke was, I could have been in the hospital for months. I was very, very fortunate.”

Mobile stroke units are a new concept in the U.S. There are only about six in service nationwide — a number that's sure to increase in the coming years.

This month, Northwestern Medicine Central DuPage Hospital will be the first in Illinois to launch one, serving patients in several DuPage County municipalities, including Winfield, West Chicago, Wheaton, Carol Stream, Glen Ellyn and Roselle. Rush Oak Park Hospital plans to put one in service, too.

“I think this will be the standard of care as time goes by. It's a phenomenal technology to have,” said Dr. Harish Shownkeen, medical director for stroke and neurovascular medicine at Central DuPage. “The treatment hasn't changed; it's the initiating of the treatment that has made the quantum leap.”

Shownkeen was vacationing in Germany a few years ago when he first heard about mobile stroke units. He witnessed one in action there and immediately decided he wanted to get it introduced where he worked.

Early studies in Germany showed that on average, stroke patients received the clot-busting drug 25 minutes faster in a mobile stroke unit than they did if they were taken to the hospital in a regular ambulance.

“Sometimes a difference of five or 10 minutes can make a difference if a person can talk or not talk, or move one side of the body or not move one side of the body, or be able to see or not see,” Shownkeen said.

When a 911 dispatcher suspects a call might be for a stroke, the mobile stroke unit and the local fire department will be alerted. Both will respond to the scene simultaneously.

Whoever gets there first will assess whether the patient should be treated in the mobile stroke unit. The unit cannot be in motion during a CT scan, so it will stay put wherever the patient is picked up.

“Even though we've added a little bit of extra time in the field, it's saving time on the back end,” said Justin Williams, Central DuPage's EMS coordinator. “What normally takes place in the ER over 15 to 30 minutes, we're doing before we even get there.”

The unit is saving not only lives, but also significant health care costs.

“They have shorter lengths of stays in the hospital, they recover faster and there's less work days lost,” Shownkeen said. “Instead of going back to work in two months or three months, they could go back to work in half the amount of time.”

Everyone involved with the launch of the unit is hopeful that as word spreads, more awareness will be raised in the community about recognizing the signs of stroke, so people don't hesitate to call 911.

Carrabba was lucky that his wife knew the signs. She was home when his stroke began and immediately made the 911 call, despite his protests, after she saw he was slurring his speech and starting to slump over. While the mobile stroke unit saved his life, it was her quick actions that gave him the shot at survival.

“I didn't realize how bad of shape I was in,” Carrabba said. “Time is of the essence. Every minute really counts.”

  Dr. Harish Shownkeen, left, medical director for stroke and neurovascular medicine, talks with Mehr Mohajer-Esfahani, stroke unit program manager, outside the state's first mobile stroke unit being launched this month by Northwestern Medicine Central DuPage Hospital. Bev Horne/bhorne@dailyherald.com
  Northwestern Medicine Central DuPage Hospital will be first in the state to launch a mobile stroke unit, which includes a CT scan. Bev Horne/bhorne@dailyherald.com
  Emergency medical technicians take part in training prior to the launch of Northwestern Medicine Central DuPage Hospital's new mobile stroke unit. Bev Horne/bhorne@dailyherald.com
Joe Carrabba, second from right, was saved by his wife, Donna, who quickly recognized he was having a stroke and called 911. He was picked up by the University of Texas at Houston's mobile stroke unit, crewed by Dr. Andrew Barreto, left, and nurse Stephanie Parker. Courtesy of UTHealth
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