“Since I am an Emergency Department Physician, it is important to stress that these regional networks focused on improving the STEMI process outside the Cath Lab, not the STEMI procedure inside the Cath Lab.
The key is combining pre-hospital ECGs and STEMI networks, as pre-hospital ECGs without the network are about as useful as a cellphone without a wireless subscription. Receiving hospitals need to act on the information prior to patient arrival (even with short transport times), especially in the current era of ED and hospital over-crowding.
Moving forward, we need to continue to encourage regular healthcare providers to become STEMI Activists who promote evidence-based “change you can believe in” in their community. A local STEMI activist works to connect ALL the regional stakeholders so that STEMI-care becomes seamless and truly integrated. Anyone can be a STEMI Activist in their region, including Cath Lab staff, ER staff, EMS personnel, QI staff, or administrators. Helpful resources include the ACC D2B Alliance, the AHA Mission: Lifeline, and the ACTION-GWTG Registry…
[T]he best part of all these efforts is the multi-disciplinary camaraderie that leads to tremendous synergy and improves STEMI care for our patients. Some patients are treated so fast, that there STEMI is essentially “time-terminated” and they walk out the hospital a few days later with preserved LV function and a minimal bump in their cardiac markers.
Finally, we need to remember that we are treating real patients in these fast systems, not just making widgets. Hence, I suggest that all the diverse healthcare providers (EMS, ED, Cath Lab) tell their STEMI patients to “think positive,” even as the team rushes to open up their blocked artery. I call this STEMI Etiquette.”
– Ivan Rokos, MD
Are you a STEMI activist? How is your STEMI etiquette?