EMS STEMI Evidence Based Measures

​EMS STEMI Evidence Based Measures

What is a STEMI or an S T segment Elevated Myocardial Infarction? STEMI is a specific type of heart attack that is detectable via a 12 Lead ECG. These patients will benefit the most from treatment at one of the eight (8) cardiac hospitals in Santa Clara County.

The first graph includes patients 35 years and older who presented with cardiac chest pain or chest discomfort.  The graph illustrates the percentage of patients who received a 12 Lead ECG and the percentage of patients who were administered Aspirin. Also shown in this graph, is the percentage of times that a patient was identified by a 12 Lead ECG as having a STEMI and was properly transported to a cardiac hospital.

The Santa Clara County EMS system had a 79% 12-lead application rate compared to an 88% seen statewide.   Using additional inclusion criteria with Aspirin administration our system is now well above the State median. 

emsSTEMImeasures

 

12 Lead: Percentage of patients age 35 and older with cardiac chest pain discomfort who received 12 lead ECG by paramedics
ASA: Percentage of patients age 35 and older with suspected cardiac chest pain who received aspirin prior to hospital by pre-hospital personnel
Proper Destination: Percentage of suspected STEMI patients transported by ground ambulance directly to a designated STEMI receiving center

When treating STEMI patients, time is always of the essence. This graph demonstrates the time spent at each of the three phases of the delivery of care: on scene, transport and at hospital up until intervention.

mediantimeforSTEMIpatients

 

The goal is 90 minutes from first medical contact to STEMI intervention by the hospital.
Each color represents who is responsible and the minutes spent for each part of the time continuum up to actual STEMI intervention.
Total time elapsed from EMS contact to hospital intervention for STEMI. Target EMS scene time for STEMI: 15 minutes or less.

This graph illustrates the time in minutes spent on scene with a STEMI patient. The mean is well below the State median.

EMSscenetimewithSTEMI2015

 

Time (in minutes) from time ground ambulance arrives at the scene until the time ambulance departs from the scene for STEMI patients.

EMS CQI Measures:

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