Excellent Care for All

Code STEMI - World Class Best Practices For Heart Attack Victims

Health Care Challenge

Cardiac teams across the province treat thousands of heart attack patients with percutaneous coronary intervention (“PCI” or angioplasty) each year. Based on the evidence, healthcare providers know that “time is muscle” and getting patients treated as quickly as possible, with the appropriate intervention, is the key to achieving positive outcomes.

“Time is of the essence when you’re talking about a patient needing emergency angioplasty,” said Marlene Allegretti, Nurse Practitioner in the Coronary Care Unit with LHSC’s University Hospital. “Once a patient starts to experience pain, we have a small window to get the patient to the hospital, diagnose the problem and open the artery.”

In the past, patients would arrive by ambulance to the emergency department at the nearest hospital, where they would be assessed and then transferred to a specialist who can perform the angioplasty.

Real Change In Action

Several hospitals around the province have launched a program called Code STEMI (after a type of heart attack called ST Elevation Myocardial Infarction) to provide faster treatment to patients experiencing heart attacks. “We know that early identification and prompt treatment of heart attacks saves lives,” says Kori Kingsbury, Chief Executive Officer of the Cardiac Care Network of Ontario.

Now, many paramedics have the ability to administer an electrocardiogram (ECG) and diagnose a potential heart attack at the person’s home or on the way to the hospital. If the results meet the STEMI program criteria, the EMS attendants alert the cardiology team that a potential heart attack victim is en route. With such programs in place, heart attack patients are transferred directly to the cardiac catheterization laboratory for angioplasty, in some cases bypassing busy emergency departments at hospitals that do not have the ability to provide advanced cardiac services.

This innovative approach results in immediate access to cardiac services in the province which reduces wait times in emergency departments and improves patient outcomes.

Ed Skrlj of Mississauga received an angioplasty in just 48 minutes from the moment paramedics arrived at his door to the insertion of a catheter in his heart. He is now on the road to a great recovery. “I was impressed with the calmness and knowledge of all the people who worked on me,” said Skrlj. “I’m positive that their timely care saved my life.”

Better Quality Care

STEMI programs are making an instantaneous impact on the speed of health care delivery. “By avoiding the ER or a stop at another hospital, we have dramatically improved door-to-treatment times,” said Allegretti. “Our average door-to-treatment time is down to about 80 minutes, well below the 90-minute target. In fact, some patients received treatment in as little as 37 minutes.”

Skrlj is grateful he received such excellent care. “It’s hard to believe that I went from my first heart attack symptoms to successful treatment in under one hour,” said Skrlj. Coordinated efforts between pre-hospital healthcare professionals and PCI programs handling STEMI cases has also had an impact on patient recovery time.  If the artery is opened within 90 minutes, it reduces the area of infarction that the patient suffers, and reduces recovery time from up to seven days to only three days.

Learn more about STEMI care and cardiac care through the Cardiac Care Network of Ontario.

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