Houston Fire Department

Community Project Funding/congressionally Directed Spending - Construction - Address: City of Houston Fire / Ems Department 500 Jefferson, 16TH Floor Houston, TX 77002 Project Director: DR. Persse Contact Phone: #832-394-6818 Email Address: David.persse@houstontx.gov Website: Http://www.houstontx.gov/mayor/ems.html Funds Requested: $906,584.00 Mobile Stroke Unit Proposal for Congress Background: Strokes Represent One of the Most Devastating Medical Catastrophes a Person Can Experience. Stroke Is Recognized as the Fourth Leading Cause of Death Among Americans, as Well as a Leading Cause of Disability. Beginning in August of 2014, the Houston Fire Department Emergency Medical Services Coordinated and Collaborated in an Aggressive Research Project With the Houston Stroke Consortium to Improve the Care of Persons Suffering From Strokes During the First Moments of Their Contact With the Health Care System. the Goal Was to Treat Eligible Patients With the Clot Dissolving Medication, Tpa, and Hopefully Reverse the Stroke Before It Causes Permanent Brain Damage. the Study Enrolled 1,047 Tpa-eligible Patients, 617 in the Mobile Stroke Unit (MSU) Group and 430 in Standard Management (SM). Among Tpa Eligible Patients, 97% Were Treated With Tpa in the Msu Group and 80% in the SM Group. Time From Last Known Normal (LKN) to Tpa Treatment Was Shorter in the Msu Group Compared to SM. Importantly, 33% of Msu and 3% of SM Patients Were Treated Within 60 Min of LKN. Compared to SM, the Msu Group Had a More Favorable Neurologic Outcome Score and the Proportion Normal or Near-normal Was 10% Higher (53% Msu Versus 43% SM). This Means That on Average, for Every 100 Patients Treated on a Mobile Stroke Unit Rather Than Standard Care, 27 Will Have Less Final Neurologic Disability and 11 of the 27 Will Be Disability-free. the Challenge Created: All Persons in the City of Houston Who Suffer an Acute Stroke Should Be Able to Receive the Superior Care and Achieve the Superior Outcomes Afforded by the Care Available With a Mobile Stroke Unit. This Community-based Msu Program Promotes Equity in All Demographic and Geographic Areas of the City of Houston: 1) Communities Disproportionately Impacted by COVID-19 (low-income Neighborhoods, Minorities, Disconnected Youth, Unemployed Veterans and People With Disabilities), 2) Negative Economic Impacted Populations and 3) Groups Historically and Marginalized by Health Disparities. However, in Order to Achieve That Level of Care Across the City, Multiple Such Msu’s Will Be Needed. Each Msu Covers an Area of ~154 Square Miles. the City of Houston Encompasses an Area of Approximately 620 Square Miles. Therefore, Four Msu Ambulances Are Required to Cover the Geographic Territory of the City of Houston. Currently Only One Msu Is in Operation Within the City of Houston / 620 Square Miles. Thus, the Ask of an Additional Msu Would Allow More Stroke Patients to Be Treated Each Day. the Solution Offered: Have the City of Houston Provided Up to Four Msu’s and One in Reserve, as Well as Paramedic Staffing While the Msu Consortium Continues to Provide Neuro-critical Care Nurse and CT Technician Staffing as Well as Tpa, Teleradiology and Teleneurology. Conclusion: This Novel Model in the City of Houston, Is Delivering Acute Stroke Treatment and Advancing Care on the Streets, Which Could Have a Potential Impact Across the Nation. When Patients Who Qualify for Tpa Compared to Standard by Ems Are Evaluated, Imaged and Treated in the Pre-hospital Setting, the Data Suggests a Saving of a Critical-hour and Fewer Long-term Disabilities, Improved Quality of Life and Reduction in Overall Healthcare Costs. in Addition, the Success of the Msu Project Has Led to Discussions by the Trauma Services of Both Baylor and Ut to Have Field Head CT’S Performed on Head Trauma Patients and Departments of Cardiology and Emergency Medicine for Both Medical Schools Are Considering High-complexity Diagnostic as We