PTFD EMS News

“Code Stemi” Program

 

STEMI stands for ST segment Elevation Myocardial Infarction, which describes a heart attack caused by a completely blocked blood vessel. This kind of heart attack affects large areas of heart muscles, and will register on a 12 lead electrocardiogram (EKG).   If time can be cut between diagnosis of a Myocardial Infarction and treatment, more of a patient’s heart muscle can be saved from damage.  The recommended time to treatment – typically with balloon angioplasty performed in the hospital’s catheterization lab is less than 90 minutes from “door to balloon”. The goal for EMS is to get patients having a heart attack to a catherization lab as quickly as possible to get the blocked arteries opened back up and resume the blood flow to the damaged part of the heart to minimize the amount of permanently damaged heart muscle. Getting heart attack patients to a catheterization lab quickly improves both survivability and long term prognosis.

  In January of 2010, using funds awarded in a federal Assistance to Firefighters Grant, Painesville Township Fire Department was able to purchase 4 new cardiac monitors.  These monitors are capable of acquiring and analyzing 12 lead EKGs.  The 12 lead EKG can then be transmitted to the emergency department with the use of a Bluetooth connection and a cell phone.  This allowed Painesville Township to collaborate with the Lake Health Systems in a new initiative called “Code STEMI” (ST elevation myocardial infarction).

 By performing and interpreting 12 lead EKGs in the field Painesville Township Paramedics are able to play a key role in reducing the time between first medical contact and catheterization in the hospital. Paramedics use information from the 12 lead EKG to triage and assess the patient. They are then able to transmit the EKG to the emergency room and call a “Code STEMI” in the field.  The “Code STEMI” immediately puts into action a plan that alerts the Emergency Room physician and a cardiologist of the patient’s condition and prepares the catheterization team for the patient’s arrival. The paramedic is then able to treat the patient and transport them to the most appropriate medical facility. Through this initiative, unstable heart attack patients from Painesville Township can be transported directly to Lake West Hospital and many times taken directly to the catheterization lab where they can receive the specialized care they need. 

Painesville Township paramedics have repeatedly demonstrated how effective the “Code STEMI” program can be in saving lives by correctly diagnosing the STEMI and transporting to a facility with a catheterization lab well within the recommended 90 minute widow.  Code STEMI has helped to move patients out of the emergency department more quickly and into cardiac intervention sooner. For most patients this means a shorter length of stay in hospital and a better chance of recovery.