Summary

Rapid response vehicles vs mobile intensive care units in prehospital stroke-code care: a retrospective cohort study

Andrea Higuera-Ruiz de la Hermosa1, Nicolás Riera-López2, Anitza Lorente-Moro3, Elena de Celis-Ruiz1, Rocío Alonso-Castillo1, Manuel Lorenzo-Diéguez1, Carlos Gómez-Escalonilla4, Carlos Estebas-Armas1, Carlos Hervás-Testal1, Ricardo Rigual1, Laura Casado-Fernández1, Laura González-Martín1, Gerardo Ruiz-Ares1, Exuperio Díez-Tejedor1, Patricia Calleja-Castaño5, Joaquín Carneado-Ruiz6, José Fernández-Ferro7, Andrés García-Pastor8, Aracelí García-Torres9, Antonio Cruz-Culebras10, Álvaro Ximénez-Carrillo11, Pilar Sobrino-García12, Beatriz Oyanguren-Rodeño13, Eduardo Escolar-Escamilla14, Laura Izquierdo-Esteban15, Blanca Fuentes1, María Alonso de Leciñana1, Jorge Rodríguez-Pardo1, en representación de la Red Ictus Madrid.

Affiliation of the authors

1Servicio de Neurología y Centro de Ictus, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital La Paz-IdiPAZ (Hospital Universitario La Paz-Universidad Autónoma de Madrid), Madrid, Spain. 2Centro Coordinador del Código Ictus, Servicio de Urgencias Médicas SUMMA-112, Madrid, Spain. 3Universidad Autónoma de Madrid, Madrid, Spain. 4Servicio de Neurología, Hospital Clínico Universitario San Carlos, Universidad Complutense de Madrid, IdiSSC, Madrid, Spain. 5Centro de Ictus, Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain. Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain. 6Servicio de Neurología, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Madrid, Spain. 7Servicio de Neurología, Hospital Universitario Rey Juan Carlos, Madrid, Spain. 8Servicio de Neurología y Centro de Ictus, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. 9Servicio de Neurología, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain. 10Servicio de Neurología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Universidad de Alcalá, Madrid, Spain. 11Centro de Ictus, Servicio de Neurología, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, IIS-IP, Madrid, Spain. 12Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 13Servicio de Neurología, Hospital Universitario de Torrejón, Madrid, Spain. 14Servicio de Neurología, Hospital Universitario de Getafe, Madrid, Spain. 15Servicio de Neurología, Unidad de Ictus, Hospital Universitario Príncipe de Asturias, Madrid, Spain.

DOI

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Higuera-Ruiz de la Hermosa A, Riera-López N, Lorente-Moro A, de Celis-Ruiz E, Alonso-Castillo R, Lorenzo-Diéguez M, et al. Rapid response vehicles vs mobile intensive care units in prehospital stroke-code care: a retrospective cohort study. Emergencias. 2026;38:416-22

Summary

Objectives.

Rapid response vehicles (RRVs) are advanced life support resources similar to mobile intensive care units (MICUs), but without patient transport capacity; therefore, they require support from a basic life support ambulance for transport to hospital. In this study, we evaluated whether the RRV care model delays stroke-code care times compared with MICUs and compared their diagnostic accuracy.

Methods.

We conducted a retrospective study of stroke codes with a known onset time attended by SUMMA-112 during 2022. We compared baseline characteristics, care times (call, assessment, door), reperfusion treatments administered, and the accuracy of the M-DIRECT scale in identifying candidates for thrombectomy between patients attended by MICUs and RRVs.

Results.

A total of 1,263 patients were included: 953 (75%) attended by MICUs and 310 (25%) by RRVs. We found no differences in call-to-assessment times (median, 27 minutes in both groups) or assessment-to-door times (median, 44 vs 46 minutes). There were no differences in the proportion of stroke diagnoses at discharge (79% vs 80%) or in the proportion of reperfusion treatments administered (thrombolysis and thrombectomy). The sensitivity rate of the M-DIRECT scale for thrombectomy treatment was 76% for MICUs and 67% for RRVs (P = .161).

Conclusions.

Care provided by RRVs showed care times similar to those observed with MICUs, with no significant differences in diagnostic accuracy, supporting their feasibility as a resource for the care of patients with acute stroke.

 

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