STEMI Bypass Protocol

Question 1

What are the 4 requirements patients need to meet for a STEMI bypass?

Answer 1

> =18 years of age

experiencing chest pain or equivalent consistent with cardiac ischemia MI

time of onset of this current episode is less than 12 hours!!

12 indicates STEMI!!

Question 2

What are the contraindications that you CANT bring to PCI??

Answer 2

1. pt is CTAS 1 and unable to secure pt airway
2. LBBB, paced rhythm or another mimicker
3. transport is >= 60 mins from pt contact
4. PCP diversion complications:
   - CPAP / mod-severe resp distress
   - hemodynamically unstable or symptomatic SBP <90mmHg at any point
   - VSA w/o ROSC

Question 3

What do we include in the patch for the receiving facility?

Answer 3

• pt is a STEMI pt
• initials of pt
• pts age
• pts sex
• paramedics concerns regarding clinical stability
• infarct territory on 12 lead
• ETA
• catchment area of pt pickup

Question 4

What is the additional info we need to tell the PCI when we get there:

Answer 4

time of onset
time of ROSC
hemodynamic status
meds given/procedures
hx of cardiac anything
ECG copy and ACR copy

Question 5

What should we do as soon as we identify a STEMI?

Answer 5

apply DEFIB PADS

Question 6

What arm should we put the IV on if we find IV access in a STEMI pt?

Answer 6

left arm!!

Question 7

If a pt becomes STEMI positive en route to ER to a NON- PCI destination, what should we do?

Answer 7

pt should be evaluated under this STEMI bypass protocol

Question 8

If the PCI doesn’t accept you, what is another thing you can do?

Answer 8

may consider an alternative PCI centre as long as they still meet the protocol

Question 9

What does PCI stand for?

Answer 9

percutaneous coronary interventionist !!!!!