Improving the System of Care for STEMI Patients Hospital 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 Hospitals (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 Duke University Hospital Vidant Medical Center 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] .