The STEMI Project:STEMI: ST Wave Elevated Myocardial Infarction (or heart attack)
- Consider this:
You are visiting your seventy-five year old mother and discover that she has been unwell all morning. She is complaining of shortness of breath, nausea, and back pain, and tells you that she can’t keep any food down. She tells you not to worry, but you insist on calling 911. When paramedics arrive, they immediately set up an electrocardiogram (ECG) to monitor her heart rhythm. A look of concern crosses their faces as they recognize an abnormal wave pattern. They contact an emergency physician at the emergency department and transmit a digital copy of the strip for confirmation. The emergency physician recommends that she be transported immediately to the cardiac catheter lab for angioplasty. She is carefully moved onto a stretcher, and loaded into the ambulance. Paramedics provide treatment including medications and continuous monitoring of the heart rhythm while en-route to the hospital. Later that day, you are sitting with your mother in recovery. She is out of immediate danger, and thankful to be alive.
The STEMI program allows paramedics to recognize a potentially fatal cardiac rhythm, send the electrocardiogram via telemetry directly to the hospital’s cardiology department, and then if necessary, transport a patient to the cardiac catheter lab for treatment. This process saves time, improves patient outcomes and streamlines appropriate medical resources. The best results happen if a patient can receive this procedure within 90 minutes from their arrival at the hospital door to the completion of the catheter procedure called a percutaneous transluminal coronary angioplasty. Early access to the system, by calling 911 is a key component of this protocol. Any patient experiencing chest pain and/or shortness of breath should access 911 immediately.
Balloon angioplasty is one of three treatments used for coronary artery disease (CAD). In CAD, the blood flow to the heart is restricted due to hardened arteries clogged with plaque deposits. The goal is to push the plaque against the arterial wall with an inflated balloon, allowing for better blood flow. This reduces the risk of further heart complications and sudden cardiac death. Other treatments for CAD are medication and bypass surgery.
The City of Calgary EMS trained all paramedics in the STEMI Protocol in 2004 and Alberta Health Services continues to train all new staff in STEMI Recognition.
In March 2005, the STEMI development team was selected by the Calgary Health Region as winners of the People First award for improving patient care.
Alberta Health Services continues to be a leader in prehospital STEMI care in North America.