Questioning the benefits of stroke ambulances seems to be in vogue lately in certain circles. In the interest of self-promotion these individuals love to point out the perceived shortcomings of others. As an EMS leader and agent of change, I feel I need to bring some clarity to this issue. I will outline the many benefits of having a stroke ambulance in your community below.

Don’t listen to the scienticians and the FOAM nerds: TPA hasn’t been proven not to work in a single clinical study. I have seen the magic of TPA firsthand, not only on strokes but also on all kinds of other things like TIAs and even hypoglycemia. If it didn’t work then obviously people would not be spending millions of dollars to put these bad boys out on the streets.  They are on the streets; therefore they have to work- that is just simple logic.

Bringing the stroke center to the patient: The public feels safer knowing that if they have a stroke ten minutes from a comprehensive stroke center that we aren’t going to make them wait for an ambulance and then drive them there, we are going to bring the stroke center to them… After they have been seen by a regular ambulance and then transferred to the stroke ambulance and after the stroke ambulance has been leveled on the side of the road and a CT scan is done. We can do everything a stroke center can with the exception of thrombectomy, intra-arterial TPA directly on the clot, other imaging, stopping intracerebral hemorrhage with clips and coils, neurosurgery and anything for stuff that isn’t a stroke. Remember time is brain.

Promotions: Unfortunately with the amount you raised the management team salaries this year there won’t be enough money left over to give everyone cost of living raises. How about offering them the chance to really make a difference in the community and drive the stroke ambulance. Remember, they’re not ambulance drivers, they’re stroke ambulance drivers and if you’re in it for the money you’re in it for the wrong reasons.

The Eagles: Do you really want to go to the Gathering of the Eagles and have to look the other Eagles dead in the eye and tell them you DON’T have a stroke ambulance? The Eagles are the best of the best with honors and once they find out you don’t have a stroke ambulance you sure as hell aren’t going to t be invited to the after-party. Hell, in 3 years you’ll be lucky if you can get into the green room at EMS Today if you don’t have a stroke ambulance.

Tax shelter – when you are a non-profit organization the last thing you want to do is show a profit. You need creative ways to hide that money and what better way than to put a million dollar CT scanner in a custom built ambulance that can sit in your parking lot 50% of the time. When employees ask about those raises you can tell them that nothing should feel as good as helping out the community and besides if they don’t like minimum wage then they should write their senator. Heck, you gave everyone agency pens last year; do you need to provide the paper as well? These God damn millennials are always asking for a handout. Seriously they should be gracious that they get to work under you as it is.

The future: next year we will begin designing the next generation of stroke ambulances by building a helicopter landing pad directly on top of our stroke ambulance. This will allow stroke patients to be flown by helicopter from scenes to a stroke ambulance and get TPA before being flown to a comprehensive stroke center.


Chet J. Reilly writes about ems leadership and can be found asking the vendors for drink coupons and swag at EMS conferences around the country. He would love to come to your agency to tell you how you should be doing things. He hopes to launch the country’s first pediatric-specific stroke ambulance in the next year. This is his first guest post on EMSQAQI. 

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2 thoughts on “Why you need a stroke ambulance by Chet J. Reilly (guest post)

  1. Brian, you are off the rails sir! You have completely missed the point on the need (or lack of) for Stroke Ambulances. Your use of satire, while funny, is not productive and just a sounding board for your agenda. This has turned from honest yet funny constructive feedback to a platform that allows you to bash anyone and everyone involved in the profession. Seriously, stop blogging and get some professional counseling.

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    1. Why don’t you explain what I am missing about stroke ambulances, and while you’re at it perhaps you should post with your real name as opposed to hiding. _ Brian

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