Evaluating the Safety and Efficacy of Telemedicine Neurology Assessments on a Mobile Stroke Unit

The goal of this clinical trial is to compare a telemedicine neurologist staffing model to a traditional on-board model in patients being assessed for suspected acute stroke on a mobile stroke unit.

This study is a prospective randomized mobile stroke unit trial comparing two staffing models: 1) a neurologist reviewing the patient via telemedicine (intervention) versus 2) an onboard neurologist assessing the patient in-person (comparator). Daily periods of remote (telemedicine) or in person (onboard) neurologist assessments will be randomly determined using an adaptive design.

Inclusion Criteria: 1. Adults \>=18 years of age 2. Presenting within 24 hours of symptom onset or last known well. 3. Patients assessed by MSU without cancellation (either by the local ambulance team or by MSU) prior to attending the patient. Exclusion Criteria: 1. Attendance of the Melbourne MSU is deemed unnecessary by either the local paramedic team or the MSU team based on provided information prior to arrival on scene. 2. The patient presents significant medical or logistical challenges which greatly delay standard treatment. 3. Any other medical contraindication at the discretion of the investigator.