Out of the Way!

The mobile stroke unit is the new, malignant, extravagant reaction to the “Time is Brain” mantra. However, not all locations are endowed with such an embarrassment of resources.

This very brief report details a systems approach in Mashhad, in Northeast Iran. In 2015, these authors reported only 1.2% of all strokes received treatment with IV tPA, and their analysis indicated prehospital delays were their primary issue. Rather than take the CT to the patient, their far more entertaining solution was simply to clear a path. To relieve delays from chronic traffic congestion and gridlock, they designed an online control system for all traffic lights to be activated based on the severity of the emergency medical condition. Green lights in a continuous path from the incident location to the medical facility help activate traffic flow to allow ambulances room to maneuver. These authors report their successful implementation reduced prehospital transfer time by 50%, although absolute measures are not reported.

Now, they do mention their next step is to report on improvements in patient-oriented outcomes. However, unless the traffic is truly catastrophic, I expect improvements in anything but process surrogates will be difficult to detect.

“Time is brain: An online controlling of traffic lights can save lives”
http://emj.bmj.com/content/early/2017/11/24/emermed-2017-206888

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