THE PULSE THE PULSE A quarterly publication of Cardiovascular Services at Advocate BroMenn Medical Center In this issue: • STEMI Patient Care • Hot Weather Precautions When Exercising – Don’t Forget About Your Pets! • CME Calendar Summer 2013 ST-Elevation Myocardial Infarction Patient Care: 2013 Updates & National Initiatives Bev Glendon RN, BSN, cardiac data and quality specialist, Cardiovascular Services, Advocate BroMenn Medical Center A ST-elevation myocardial infarction (STEMI) is a severe heart attack whereby the blood flow is blocked to the affected heart muscle. This lack of blood flow causes heart muscle to die. Hence, the sooner the artery is opened the less cell death there will be. For more than 20 years, evidence has demonstrated that mortality in patients having an ST-segment elevation myocardial infarction (STEMI) is reduced with rapid coronary reperfusion. Percutaneous coronary intervention (PCI) with balloon angioplasty and/or stent deployment is the preferred treatment over intravenous fibrinolytics, if it can be done in a timely manner. Transfers to PCI hospitals from non-PCI hospitals can pose challenges to timely reperfusion. A survey conducted by the American Heart Association between April 2008 and January 2010 received feedback on STEMI care practices from 899 PCI hospitals in 47 states, including 381 systems of care. A STEMI system is defined as an integrated group of separate entities involved in STEMI reperfusion therapy within a geographic area. It involves at least one PCI hospital and one emergency medical service (EMS) agency. The survey results demonstrated processes that hospitals and EMS practice: • Accepting patients at a PCI hospital regardless of bed availability (97%) • Single phone call activation of the catheterization laboratory (92%) • Emergency Department physician activation of the lab without cardiology consult (87%) • Pre-hospital activation of the STEMI team through emergency department notification without cardiology notification (78%). The barriers included: • Hospital (37%) and cardiology group competition (21%) • EMS transport and finances (26%) Of interest is that 61% of the systems reported having protocols that allowed for diversion to a PCI hospital for patients with a pre- hospital ECG demonstrating a STEMI. Some protocols were independent of
Transcript
The PulseThe Pulse
A quarterly publication of Cardiovascular Services at Advocate BroMenn Medical Center
In this issue:• STEMIPatientCare
• HotWeatherPrecautionsWhenExercising
–Don’tForgetAboutYourPets!
• CMECalendar
Summer 2013
sT-elevation Myocardial Infarction Patient Care: 2013 updates & National InitiativesBev Glendon RN, BSN, cardiac data and quality specialist, Cardiovascular Services, Advocate BroMenn Medical Center
O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines J Am Coll Cardiol 2013:61:xxx-xxx. Doi:10,1016/j.jacc.2012.11.018.
Jollis JG, et al. Systems of care for ST-segment-elevation myocardial infarction: A report from the American Heart Association’s Mission: Lifeline. Circ Cardiovasc Qual Outcomes 2012;5:00-00.
hot Weather Precautions When exercisingCheryl Richards, exercise physiologist, Cardiac Rehab, Advocate BroMenn Medical Center
Don’t Forget About Your PetsPetownersareurgedtorememberthefollowingtips:Neverleavepetsinaparkedcar.Onawarmday,temperaturescanrapidlyrisetodangerouslevels.Ifyouseeananimalindistressinaparkedcar,contactthepolice.Evenwiththewindowsslightlyopen,thetemperatureinacarona93-degreedaycansoarto125degreesinjust20minutesandapproximately140degreesin40minutes.
