Screen shot 2012-03-27 at 12.53.29 PMTaking care of patients with an acute myocardial infarction is tough; but how can we improve this process? “WE” as a healthcare system share the responsibility to identify, transport, treat, and discharge these patients as quickly and efficiently as possible. There are a LOT of moving pieces to this puzzle. Lets look at some of the current challenges we face:

 

  • patients need to know the warning signs (public education)
  • patients need to activate the 911 system early (public education/resources)
  • EMS teams need to respond quickly and evaluate the patient (EMS/Regional resources)
  • decrease time to the intial 12-lead (EMS training/education)
  • recognition of acute changes on EKGs consistent with acute MI pattern (EMS training/education)
  • sharing information to facility (EMS, ED, Cardiology)
  • Early notification of cath lab (EMS, ED, Cardiology)
  • rapid transport of patient to appropriate facility (EMS/Regional system)
  • rapid turnover of patient care from EMS to ED (EMS/ED)
  • ED registration of the patient and consent
  • rapid initial physician evaluation of the patient
  • confirmation of AMI on EKG
  • bloodwork obtained
  • initial radiographs obtained
  • consent obtained for procedure
  • specialist consult
  • preparation of patient for cath lab
  • transportation of the patient to cath lab
  • sedation of the patient
  • vascular access for procedure
  • cannulation of vessel
  • identification of blockage
  • intervention at blockage site
  • recovery of the patient
  • transport to critical care bed
  • consultations
  • discharge management
  • cardiac rehab
  • follow up
  • prevention

As you can see, there is a LOT that goes into the overall recognition, transport, treatment, rehabilitation of a patient with an AMI