Transcript stemi protocol

STEMI PROTOCOL
UNION HOSPITAL
EMERGENCY DEPT.
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Presentation of Patient

Patient
presenting to ER
with acute chest
pain suspicious
of cardiac origin
will have chest
pain orders
initiated upon
arrival.
Communicate
with Sec. to
order Labs/Xray.
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ER ECA/Charge Nurse Role
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Greeter will notify Via Vocera
that STAT EKG needs done.
This must be done when patient
is being taken to room to ensure
EKG completed in 10 minutes.
ER will only be responsible for
the EKG. Once EKG performed,
it is to be immediately handed
delivered to the ERMD for
interpretation.
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Care of Patient
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Triaging the patient and getting their
medical information takes second
priority to getting EKG, placing the
patient on Oxygen and application of
cardiac monitor, initiation of IV and
having blood work drawn.
If EKG reveals ST Elevated
Myocardial Infarction(STEMI) the
ERMD will initiate the STEMI
standard order set.
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STEMI Routine Orders
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Care of STEMI Patient
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Upon notification of STEMI routine
orders nurse will ensure that routine
orders had been initiated.
Administer medications according to
routine order sheet. Utilize STEMI
Drug Box. Remove under STEMI
drug box in Pyxis. Integrillin kept in
Pyxis. Fax Drug sheet to pharmacy
to show STEMI Drug box used and
needs refilled.
Obtain consent for “Left Cardiac
Catheterization with Possible
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Care of STEMI Patient Cont’d.
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Ensure that patient completely
undressed.
If time permits, clip hair in 8 inch
circle on both sides of groin.
Assist with transfer of patient to
Cath Lab upon their arrival.
Send original chart with patient
including consent and STEMI
Flowsheet/Timer/Clipboard
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Role of ER Secretary
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Upon notification from greeter of need for EKG ER
ECA or Charge Nurse will be notified of need for
EKG, if they are unable to perform page CVT by
putting room # and chest pain in pager. To ensure
that patient receives EKG within 10 minutes of
arrival.
If coming by EMS 12 Lead EKG will be transmitted
via Lifenet Alert.
ERMD will notify secretary to page cardiologist per
STEMI paging protocol, picked by: Patient’s private
cardiologist or his on call coverage, PCP usual
preference, or Interventional Cardiologist on call.
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Role of ER SEC Cont’d.
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ER Sec will log times called and received. The
cardiologist will be called every 5 minutes. If no
answer in 10 minutes, go to next one on list,
i.e.Interventional Cardiologist on call.
The ER sec will fax EKG if requested.
If 12 Lead via Lifenet, EKG will be forwarded to
Cath Lab.
The ER sec will simultaneously page the Cath lab
per STEMI Paging Protocol.
Cath lab will return call to STEMI phone(238-7772)
STEMI Flowsheet/Timer/Clipboard will be sent to
cath lab upon patient transfer.
After 6pm, notify house supervisor and security to
open Cath Lab
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