Working on our STEMI policy

[Sully Nurse]

We are current working on our STEMI policy. Our health grades in this area are very poor. We were once know as the place to go for open heart, needs. I would like to know how some of your hospitals run their STEMIs. Currently, in our facility, for in patients, only a physician or resident can call a STEMI alert. The nurse is required to obtain an EKG and wait for a medical resident to read the EKG. If they cannot read it, then the EKG goes to the cardiologist, who may be on call, in house, sleeping, out with the family, etc. Sometimes they call back quickly, other times, not. These nurses are Dysrhythmia and ACLS certified. Cath lab personnel are not mobilized until the call is received from the physician. What would some opinions be of a STEMI standby alert, where a nurse makes the call, teams are mobilized, cardiologist is called and informed while EKG is being transmitted. Worst case scenario, the cardiologist deems the EKG negative for a STEMI and everyone receives the all clear page and goes home.

Looking for ideas and some devils advocate feedback to make this new policy as airtight as possible.

[Bobjohnny]

Are you looking to rework the policy for ED, inpatient, or both? Do you have hospitalists if reworking the inpatient side?

We currently do something similar to what you indicated. Only a provider(Doc, NP, PA or resident) can call a STEMI alert. We also have in addition to 2-3 ED providers at all times, at least 2 hospitalists at all times.