A History of Mobile Stroke Units and Review of Literature

Breaking Barriers in Stroke Therapy: Recent Advances and Ongoing Challenges

Acute ischemic stroke remains a significant global health challenge, prompting notable advancements in its management. Diagnostic innovations, including advanced imaging techniques and biomarker discovery, have greatly improved early detection and treatment precision. Mobile stroke units have expedited pre-hospital care, emphasizing the urgency of intervention under the principle "time is brain." These developments underscore the importance of timely and accurate diagnosis in improving outcomes. Therapeutic breakthroughs in thrombolytic therapy and mechanical thrombectomy have transformed acute stroke treatment. Refined thrombolytic protocols, new agents, and extended treatment windows have expanded therapeutic possibilities. Mechanical thrombectomy, bolstered by improved devices and techniques, has achieved higher recanalization rates and broader applicability, solidifying its role in endovascular interventions. Meanwhile, post-stroke care has embraced personalized, multidisciplinary rehabilitation approaches, with telemedicine breaking geographical barriers and enhancing recovery through patient-centered models. Despite these advancements, challenges persist, including disparities in access to advanced care and the underexplored management of minor strokes. Emerging technologies, such as artificial intelligence and machine learning, offer opportunities for better risk prediction and earlier interventions, though their long-term impacts require further study. This review highlights the transformative progress in stroke care while emphasizing the need for continued innovation, research, and equitable access to ensure better outcomes for all patients.

Care of the Patient With Acute Ischemic Stroke (Prehospital and Acute Phase of Care): Update to the 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association

The year 2020 was the year of the nurse, celebrating nurse scholarship, innovation, and leadership by promoting scientific nursing research, improving nursing practice, advancing nursing education, and providing leadership to influence health policy. As architects of stroke care, neuroscience nurses play a vital role in collaborating and coordinating care between multiple health professionals. Nurses improve accessibility and equity through telestroke, emergency medical services, and mobile stroke units and are integral to implementing education strategies by advocating and ensuring that patients and caregivers receive stroke education while safely transitioning through the health care system and to home. Stroke care is increasingly complex in the new reperfusion era, requiring nurses to participate in continuing education while attaining levels of competency in both the acute and recovery care process. Advanced practice nurses are taking the lead in many organizations, serving as prehospital providers on mobile stroke units, participating as members of the stroke response team, and directing stroke care protocols in the emergency department. This scientific statement is an update to the 2009 "Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient." The aim is to provide a comprehensive review of the scientific evidence on nursing care in the prehospital and hyperacute emergency hospital setting, arming nurses with the necessary tools to provide evidenced-based high-quality care.