Just like a Trauma criteria patient can be taken directly to a trauma center and stroke patients are taken directly to a stroke center, a known STEMI patient should be transported directly to a STEMI Receiving Center.
STEMI Receiving Centers
STEMI’s can be transported to VBGH, SLH and CRMC. STEMI receiving centers must meet certain criteria including being open/on call for 24 hours a day.
SPAH and SI are NOT STEMI receiving centers. Even though it may have a cath lab, SPAH is not open 24 hours a day nor did it go through the process to become a receiving center. Please ensure that you send all EKG’s that don’t print out “STEMI” to these facilities early so they can make a determination if they will accept the patient or not.
If you perform a 12-lead and your patient indicates a STEMI, you do not have to contact a closer facility if they are not a STEMI center unless you have a truly unstable patient and need to consult with that facility for direction.
If you have a questionable case that could be a STEMI (patient has strong symptoms but the 12 lead is ambiguous) transmit your 12 lead early and call the closer facility early. This consultation should be made before leaving the scene so you know which direction to head and the doctor has time to review the 12 lead. If there are any changes in patient status, always notify the facility that is expecting you.
Remember to always transmit your 12 leads and send them early (with a quick follow up call) so they can activate the STEMI alert as early as possible!
STEMI goals for VBEMS, theregion and AHA include the following:
- First Medical Contact (FMC) to 12 lead: 10 minutes or less
- Transmission of STEMI EKG: 10 minutes or less
- Ambulance onscene time: 15 minutes or less
- FMC to balloon: 90 minutes or less.
- This includes EMS, ED and cath lab time which is why early activation of the STEMI alert is important. Time is muscle!
- Don’t forget ASA and NTG
Please visit the TEMS site and review the Tidewater EMS Regional STEMI plan for lots of information and definitions at : http://tidewater.vaems.org/performance-improve-mainmenu-112/tems-triage-plans/stemi-triage-plan/file
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