Working against the clock
STEMI team mobilizes quickly for patients suffering from serious heart attacks
At any moment a patient with a STEMI could arrive at the UF Health Shands E.R. When they do, time is of the essence, and our STEMI team provides top-notch care faster than the national goal.
What is a STEMI?
A STEMI is the deadliest form of heart attack. The name is an acronym for ST elevation myocardial infarction. In a STEMI, the coronary artery is completely blocked off by a blood clot, and as a result virtually all the heart muscle being supplied by the affected artery starts to die. This severe type of heart attack is usually recognized by the characteristic changes it produces on an electrocardiogram, or ECG. One of those ECG changes is an elevation in what is called the “ST segment.” The elevated ST segment indicates that a relatively large amount of heart muscle damage is occurring (because the coronary artery is totally occluded) and this is what gives this type of heart attack its name.
What is the team’s biggest challenge?
“Time is critical for patients experiencing STEMI,” said Carla Schmidt, B.S.H., CCCP, C.V.T., UF Health Chest Pain Center STEMI coordinator. “The precision and excellent skills of multiple teams have allowed us door-to-balloon times* well below the national goal.”
* The amount of time between a heart attack patient’s arrival at the hospital to the time he/she receives percutaneous coronary intervention, or PCI, such as angioplasty.
What makes this team special?
“Of course, as any critical care STEMI team knows, for the patient with a STEMI, time is muscle. The sooner we can re-establish blood flow to the heart muscle by opening an occluded coronary artery, the more heart muscle is preserved and less damage occurs,” Schmidt said. “For the patient, that can mean the difference in resuming the lifestyle they are used to or becoming an individual with a failing heart. By working rapidly together, this team knows they are providing the best possible outcome for the patient.” N&N
What happens when a STEMI alert goes out?
UF Health ShandsCair dispatch receives a report from EMS that they are currently inbound with a patient with a STEMI and issues a STEMI alert.
Here’s how we mobilize:
A critical care team of nurses and physicians in the E.R. prepares for the patient’s arrival. This team includes a critical care tech for electrocardiogram, at least two E.R. nurses, an E.R. attending and resident physicians, a fellow, an X-ray tech and a pharmacist.
Stat nurses head to the E.R. to assist staff with patient care and transport the patient to the cardiac catheterization lab.
The cardiac cath team prepares for the patient’s arrival while cardiology fellows and attending physicians care for the patient in the E.R. The cardiac intensive care unit (CICU) prepares for the patient’s arrival to their unit post cath/intervention.