Improving the System of Care for STEMI Patients fibrinolysis: POE Protocol Door-to-needle within 30 min

STEMI-referral hospital (non PCI-capable)

EMS on-scene Onset of EMS 9-1-1 • Encourage 12-lead ECGs symptom Triage EMS • Consider prehospital fibrinolytic if of STEMI Plan dispatch capable and EMS-to-needle within 30 min STEMI-receiving hospital GOALS† (PCI-capable)

EMS transport: Patient Dispatch EMS on scene EMS transport EMS-to-balloon within 90 min 5 min after 1 min within 8 min Prehospital fibrinolysis: Patient self-transport: symptom onset EMS-to-needle within 30 min Hospital door-to-balloon within 90 min

Total ischemic time: Within 120 min* * Golden Hour = First 60 minutes 11/19/2012 ©2011, American Heart Association 2 ©2012, American Heart Association 3 Mission: Lifeline -- Recognition

•STEMI Referral (non PCI) •STEMI-Receiving Hospitals (PCI) •EMS •STEMI System

BRONZE = 1 QUARTER SILVER = 1 YEAR GOLD = 2 YEARS (Repeat Bronze)

4 Mission: Lifeline® Recognition Awards

Announced in U.S. News & World Report (July)

• 221 US hospitals earned this honor in 2012 • 20 are in North Carolina

©2012, American Heart Association 5 Mission: Lifeline Recognition Awards

Gold Carolinas Medical Center CMC- Northeast *Frye Regional Medical Center High Point Regional Health System Presbyterian Hospital University of North Carolina Hospital WakeMed Health and Hospitals

11/19/2012 ©2012, American Heart Association 6

Mission: Lifeline Recognition Awards

Silver Durham Regional Hospital New Hanover Regional Medical Center

Presbyterian Hospital – Huntersville Presbyterian Hospital - Matthews

11/19/2012 ©2012, American Heart Association 7 Mission: Lifeline Recognition Awards

Bronze Cape Fear Valley Medical Center Carolina East Medical Center CMC- Mercy Caromont Health/ Gaston Memorial Cone Health Wake Forest Baptist Medical Center

Central Carolina Hospital 11/19/2012 ©2012, American Heart Association 8

Data Slides

• Will be provided upon request to:

• Elynor Wilson – [email protected]