WakeMed Code STEMI Reduces Heart Attack Patients' Time to Treatment by 46 minutes
Coordinated Response Between EMS, the ED and Cath Lab Improves Patient Outcomes
RALEIGH, NC � WakeMed Health & Hospitals� Raleigh Campus Code STEMI (ST-Elevation Myocardial Infarction) Response Plan has reduced the time Acute Coronary Syndrome (ACS) and Acute Myocardial Infarction (AMI or heart attack) patients receive treatment in the Cath Lab from 124 minutes to 78 minutes in only two months.
This plan, which began on March 13, is part of WakeMed�s Chest Pain/Heart Attack ongoing initiatives that are dedicated to decreasing mortality and improving functional outcomes in patients presenting to WakeMed with acute coronary syndrome or a heart attack.
More than 860,000 Myocardial Infarctions (heart attacks) happen in a year resulting in 213,000 deaths. At least half of those die within one hour of symptoms showing,� said Betsy Gaskins-McClaine, executive director of the WakeMed Heart Center.
Since time is heart muscle and preservation of heart muscle and function helps decrease mortality and reduce heart failure, the goal of the Code STEMI Response is to ensure that WakeMed achieves the American College of Cardiology clinical standard that patients presenting with acute ST segment elevation MI get to the cardiac catheterization lab and have a balloon inflated opening the artery in less than 90 minutes. Our results thus far have surpassed the 90 minute goal.�
Emergency department physicians activate the Code STEMI Response Team when a patient presents to the emergency department (ED) with acute changes in ST segment elevation noted on the electrocardiogram (ECG). Or, if Wake County EMS personnel respond to a call where a patient has acute ST segment elevation, Wake County EMS will notify the WakeMed Emergency Department physician who activates the Code STEMI team. To expedite this process, Wake County EMS recently added the capability to transmit ECGs directly to the ED from the field, enabling ED physicians to review the information and initiate a Code STEMI even before the patient arrives.
The Code STEMI Response represents several process changes directed at reducing time to treatment of Acute MI patients:
1.) ED activation of the Cath Lab call team as soon as the Acute ST segment elevation MI is recognized on the ECG. The result is the patient spends a shorter time in the ED prior to going to the Cath Lab for intervention to open the blocked artery.
2.) Early deployment of heart attack specialty resources (Code STEMI team) to support rapid treatment and transfer of the patient by the ED physician and nursing staff, including the patient�s cardiologist/interventional cardiologist on call, a critical care unit (CCU) nurse, Invasive Cardiology specialists, Cardiology nurse practitioners/Physicians Assistants, Respiratory Therapy and the Clinical Administrator.
3.) Improved timeliness to access ECG data for collaboration between ED physician and the cardiologist via use of the dedicated Internet STEMI email account.
Code STEMI success is the result of the hard work of many resources performing together to deliver the best possible care in the fastest time possible,� commented Janice Frohman, director, WakeMed Raleigh Campus Adult Emergency Department. The best reward for the reduced time and coordinated efforts are better outcomes for our patients, preventing death and resulting in less disability.�
