By 2022, the Mobile Stroke Unit - Stroke One Stop model was in place to provide medical care across the entire country, addressing the shortage of medical teams and facilities, as well as the patient transfer issue, particularly in remote areas. Thanks to the collaboration of both government and private organizations, the operations have now become world-class stroke recovery and a model for any future emergency service practice.

Our future plan;

Increasing service coverage to Lang Suan District, Chumphon Province, and Nan Province.

Creating a floating MSU model, Si-CAT MSU-1, capable of performing CT scans and operating on water, with the first release planned for the Chao Phraya River.

If you or a family member is experiencing symptoms such as acute hemiparesis, facial palsy, or slurred speech, please remain calm and dial '1669' to register with the emergency service for a rapid primary diagnosis.

MSU-SOS (Mobile Stroke Unit, Stroke One Stop)

Stroke is currently a major public health concern around the world. To restore blood circulation, stroke treatment must initiate within 4.5 hours by administering a thrombolytic agent concurrently with transcatheter thrombectomy. Time is of the essence in stroke treatment; the earlier treatment begins, the faster the patient recovers. However, in Thailand, there are significant limitations in terms of the number of operating doctors and support teams, as well as high equipment costs. As a result, MSU-SOS may only be available at a few medical schools and in private and large hospitals.

Stroke treatment is a race against time since it claims the lives and disables a large number of Thai and foreign people, with the "time standard" of 270 minutes being a significant factor in minimizing disability and mortality. That is, the sooner the symptoms are discovered, the sooner the diagnosis, and thus the greater the likelihood of recovery. This is why a Mobile Stroke Unit is an essential tool for medical personnel.

Siriraj Stroke Center, Faculty of Medicine Siriraj Hospital, Mahidol University, in collaboration with the Faculty of Engineering, Mahidol University, and partners, established Mobile Stroke Unit, Tele Consultation, and Patient Transfer; A One-Stop Service for All or MSU-SOS, which stands for Mobile Stroke Unit, Stroke One Stop. Currently, the collaborative efforts of both faculties and RMA Automotive Co., Ltd have resulted in 6 Mobile Stroke Units that are operational and continue to improve.

MSU-SOS is a model project that aims to improve the efficiency of teleconsultation and Ischemic stroke treatment using a Mobile Stroke Unit. The onboard CT Scanner, which is teleconsultation compatible, scans an image of the patient's brain and communicates with a medical team via 4G/5G technology, a high-speed wireless network, to make an immediate decision to deliver a thrombolytic agent. It also enables the medical team to inject contrast media to monitor cerebrovascular functions, resulting in a faster and more accurate diagnosis and a shorter referral procedure. As a result, the rate of disability, mortality, and loss to the patient and family is lowered, and the expense of the fund for long-term disabled patient care is reduced.

The Mobile Stroke Unit - Stroke One Stop (MSU-SOS) is a mobile medical unit designed specifically for acute stroke treatment. It combines advanced engineering technology, cutting-edge medical technology, and a stable 5G mobile communications system installed in the vehicle. The mobile stroke unit is equipped with a brain CT scanner for diagnostic purposes and has been certified by relevant government agencies for radiation safety, transport safety, and emergency medical safety. It has also undergone extensive engineering tests that exceed standard requirements. The medical team has been trained in acute stroke care and works under the guidance of specialized doctors to ensure the safety and readiness of the vehicle. The unit meets treatment standards and can provide rapid care for stroke patients, with an average operation time of 28 minutes.

MSU-SOS is accessible 24 hours a day, seven days a week. Since May 18, 2018, the Mobile Stroke Unit has treated over 1,900 patients , demonstrating that it improves treatment efficiency and lowers disability rates. Furthermore, patients will have more equitable access to public health and treatment when they enter the unit. Under the guidance of the Faculty of Medicine Siriraj Hospital, the Mobile Stroke Unit is currently expanding its service to various regions across the country, including;

Bangkok metropolitan area; managed by Mahidol University's Faculty of Medicine Siriraj Hospital.
Chonburi Province; collaborated with Burapha University Hospital and Chonburi Hospital (To initiate a prototype for other areas in the Eastern Region)
Ratchaburi Province; collaborated with Chom Bueng Crown Prince Hospital, Photharam Hospital, Ratchaburi Hospital (To initiate a prototype for other areas in the Western Region)
Surat Thani Province; collaborated with Khiri Rat Nikhom Hospital, Surat Thani Hospital, Trang Hospital, and Songklanagarind Hospital (To initiate a prototype for other areas in the Southern Region)
Chiang Rai Province; collaborated with Chiang Khong Crown Prince Hospital and Chiang Rai Prachanukroh Hospital (To initiate a prototype for other areas in the Northern Region)
Nakhon Phanom Province; collaborated with Thatphanom Crown Prince Hospital and Nakhon Phanom Hospital (To initiate a prototype for other areas in the Northeastern Region)
Krabi Province; collaborated with Khlong Thom Hospital.
Nakhon Si Thammarat Province; collaborated with Cha-uat Hospital.

On 7th November 2022, the Faculty of Medicine Siriraj Hospital, Mahidol University, unveiled a new generation of Mobile Stroke Unit, MSU-SOS 2023, with a more vital capability in treatment service that can scan, treat, and transfer in one stop. The unit was the first in the Asia-Pacific region and the second in the world, with a door-to-needle time of less than 15 minutes. In any case, stroke affects approximately 13.7 million people worldwide. Thailand's incidence is 328 per 100,000 people, with a mortality rate of 10% and a disability rate of 60%. It is still increasing.

The accomplishment of this cutting-edge technology and telemedicine in MSU-SOS is the result of ongoing advances in engineering and medical technology, as shown below.

Construction of a new, developed, and certified unit to support the installation of a 16-Slice CT Scanner.
New engineering design for maximum safety in car accidents and crashes.
A new electrical system can run for more than three hours without being powered by the engine or other sources.
A new effective communication system that supports real-time 5G wireless technology with edge computing to enable cloud access and evaluation of patients' AI cerebrovascular imaging and database.
With a door-to-needle time of less than 15 minutes, a workflow was designed to simplify goal processing in an emergency.

The Mobile Stroke Unit's trademark "MSU-SOS" has now been registered. This is a breakthrough in Thai innovation to enhance life quality by reducing disability and mortality caused by stroke. Furthermore, it encourages Thailand to become a "Healthy Thailand" and a world leader in medical innovation, attracting both domestic and international attention, including the United States, Australia, Malaysia, and Indonesia.

For more information, please contact the Institute for Technology and Innovation Management (INT), Mahidol University, at (+66) 2-849-6050.

Siriraj Hospital's role as a National Institute of Emergency Medicine-certified stroke advisory operating unit is to provide specialized medical operations advice to stroke units nationwide.

The 'Mobile Stroke Unit - Stroke One Stop (MSU-SOS)', an all-in-one vehicle equipped with teleconsultation services and extensive referral capabilities for acute stroke patients, was delivered to the Khlong Thom Hospital in Khlong Thom District, Krabi Province, in April 2023. The MSU-SOS is capable of providing comprehensive acute stroke care, including diagnosis, treatment, and patient transfer.

This effort was started to address acute stroke cases in Krabi Province, notably in three districts: Mueang Krabi, Khlong Thom, and Lam Thap, which saw a significant number of stroke cases in 2022, ranking among the province's highest points. The MSU-SOS, with onboard CT-Scan technology as the primary diagnostic tool, ensures swifter diagnosis and treatment, resulting in higher survival rates and reduced handicap.

The Health District 11 Service Plan Committee for Stroke identified Cha-uat District in Nakhon Si Thammarat Province as a pilot region for establishing mobile stroke care systems in June 2023. The MSU-SOS has been delivered to Cha-uat Hospital for collaboration with the Siriraj Stroke Center, Faculty of Medicine Siriraj Hospital. This collaboration aims to increase accessibility, shorten treatment durations, and reduce disability and mortality rates in the Cha-uat District.

Siriraj Mobile Stroke Unit Creates a New Acute Stroke Treatment Paradigm and Wins World-Class Awards at the 'WorldInvent 22+23 Singapore International Invention Show' (WoSG)!

Selected by The National Research Council of Thailand (NRCT), on September 4th–6th, 2023, Assoc. Prof. Yongchai Nilanon, MD, the President of Siriraj Stroke Center, Siriraj Hospital, along with Asst. Prof. Pornchai Chanyagorn, Ph.D., the Deputy Dean for Process Quality Development, Faculty of Engineering, Mahidol University, and the team from Siriraj Stroke Center, had the opportunity to showcase their research and inventions, "Siriraj Mobile Stroke Unit—Stroke One Stop," at the "WorldInvent 22+23 Singapore International Invention Show (WoSG)" at D'Marquee, Downtown East, Singapore.

Notably, the "Siriraj Mobile Stroke Unit - Stroke One Stop (MSU-SOS)" won two prestigious awards including,

The "Gold Medal Award" for outstanding achievements in inventions and innovations
The "World Champion Innovation"

Siriraj Stroke Center has recently launched the latest version of its Mobile Stroke Unit, named "MSU-SOS 2023," the sixth unit in its series. The MSU-SOS is known for its cutting-edge technology, such as a mobile 16-slice CT scanner on a moving vehicle. It comes with 5G connectivity, teleconsultation capabilities, an Edge Computing system, and AI on Cloud, which can diagnose and treat patients within 15 minutes. Moreover, it boasts advanced engineering for enhanced safety in case of accidents.

Notably, this Mobile Stroke Unit is the first of its kind in the Asia-Pacific region and the world's second mobile stroke unit ambulance equipped with a 16-slice CT scanner. This CT scanner serves as an all-in-one solution for acute stroke treatment and sets the standard for mobile stroke unit ambulance design, making it a pioneering model for acute stroke treatment in Thailand.

Furthermore, the services offered by the Mobile Stroke Unit, encompassing scanning, treatment, and patient transfer, have been trademarked as "MSU-SOS." This innovative approach has been particularly beneficial for remote and resource-limited areas, leading to a significant reduction in disabilities and fatalities resulting from strokes. Additionally, the Siriraj Stroke Center has applied for a Thai patent in the 'Patent for Invention' category (patent number: 2101003983) under the name "Vehicle for Diagnostic Radiology" as of July 1st, 2021. Moreover, the Siriraj Stroke Center has also initiated the process of applying for an international patent through the Patent Cooperative Treaty (PCT), with the patent application number WO2023/277828A2. In the next steps, considerations will be made to enter the 'National Phase' to harness potential commercial benefits in the future.

The results of the Mobile Stroke Unit's services show that acute stroke treatment through the MSU-SOS can reduce treatment time by 50%, triple the rate of patients receiving thrombolytic therapy or catheter-based interventions, and double the rate of patients recovering from disability. In addition to the mobile stroke unit service, the Faculty of Medicine Siriraj Hospital is developing the "Siriraj Catamaran Mobile Stroke Unit (SiCAT MSU)" to enhance stroke care for residents along both sides of the Chao Phraya River. This service is planned to launch at the end of 2023 and will serve as a model for other regions in the country.

For the results achieved by the Mobile Stroke Unit, patients now receive thrombolytic medication within just 20 minutes of arriving at the unit, significantly increasing their chances of unblocking blocked blood vessels and achieving recovery. This has led to an outstanding level of treatment, with 60 percent of patients regaining their self-dependence. According to previous studies and comparative analyses of stroke treatment indicators and outcomes, when comparing patients who transport themselves to the hospital, those who are transported by Emergency Medical Service (EMS) ambulances, and those who receive treatment from the Mobile Stroke Unit, it becomes evident that the time it takes to administer thrombolytic medication has significantly decreased.

In addition to the Mobile Stroke Unit service, the Faculty of Medicine at Siriraj Hospital is actively working on the development of the "Siriraj Catamaran Mobile Stroke Unit - SiCAT MSU." This initiative aims to enhance stroke care services for residents living on both sides of the Chao Phraya River. The anticipated launch date for this service is late 2024, and it is expected to serve as a pioneering model for similar services in other regions of the country in the years to come.

From 2024 to 2026, under government policy and collaboration among various ministries, the Foundation For the Crown Prince Hospital, and the Office of The National Broadcasting and Telecommunications Commission, the service area will be expanded to remote regions surrounding the Crown Prince Hospital and throughout Thailand, covering a total of 21 provinces.

Note: Observe F.A.S.T. symptoms as warning signs of a stroke

Face:       Face or mouth drooping
Arm:       Weakness in one side of the arm or leg
Speech: Slurred speech or inability to speak, some may not understand commands or speech at all
Time:    If any of the above symptoms occur, it is crucial to rush to the hospital as quickly as possible.