Responding to the ER for STEMIs

andi.w · Feb 21, 2013

If EMS picks up a STEMI or if a STEMI walks into the ER, we activate an AMI page, and a page is sent out to the interventional cardiologist, Cath lab team, and the CVICU unit. A nurse from CVICU does not respond to the ER, however. The ER staff are for the most part extremely efficient in meeting the core measures/goals for AMI. I think that a "chest pain" nurse would be a good way to facilitate fluidity in caring for STEMI patients, especially since most hospitals have short windows of time for interventions.

MomRN0913 · Feb 21, 2013

Usually the Ron's from the other units ( such as Cath lab or cv icu) but are notified. I worked in the ICU where " code hearts" were called and we were notified by the nursing supervisor as soon as it was called, got a bed available, all the equipment and so on and so forth.I worked as an outcomes manager for a Cath lab where all were notified but didn't respond, however, the Cathlab nurses CHOSE to respond in the ER so they knew exactly what they were getting. Hope this help.

coco317 · Feb 21, 2013

My hospital does this and it's proven to be very beneficial to our patients and has brought our average door to balloon time down -- our record is 9 minutes! We call it a 'Code STEMI' - it's paged overhead. Cath lab is paged in from home during off hours. The ER RN is to remain in the room up until the cath lab team takes the patient. Our surgical house doctor who oversees the CVICU responds and assumes care for the pt collecting a quick H&P and gives the ER nurse verbal orders on titrating NTG gtt or administering heparin or morphine. The CVICU RN records vitals, labs drawn and the results, history, allergies, meds given, presenting symptoms and talks with the patient and family about what to expect during their hospital stay. The CVICU RN is the messenger in a sense and we also get a solid rapport with patient and family. A respiratory therapist always responds too for the occasional respiratory compromised/real sick STEMIs. As soon as the cath lab team and cardiologist arrive we are wheeling down to cath lab.

Jsconce · Feb 21, 2013

I am currently helping to develop a chest pain response team in our hospital.We are a 36 bed ER and regional medical center with interventional cardiology.
Specifically I am looking at the role a Cardiovascular ICU nurse would play as part of the CP response team. This means that anytime there is a STEMI verified by EKG or EMS a page goes out to the "chest pain team". RT, CVICU RN, Lab, Cardiology, and Cath lab are all notified.
Does your hospital utilize such a team in the ER?
Does that team use a CVICU RN?
If it does, what is the role of the CVICU RN?
Thanks for your time!
(I will also post this in ER section)

We have a separate unit in our facility that has 3 teams of 4 that are on call every 3rd day and every 3rd weekend. Usually made up of two techs & two cardiac nurses. Our unit is on call for STEMI's and emergent pacemaker implants 24/7. The paramedics in the field and ER are a crucial part of the process of ECG recognition and paging the team. After the pt is fixed they transfer to ICU. It's a beautiful thing when all groups work together to save that muscle :)