Challenging Case Presentations From South Texas Methodist Hospital

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Presentation transcript:

Challenging Case Presentations From South Texas Methodist Hospital REGIONAL SYSTEMS OF CARE DEMONSTRATION PROJECT: MISSION: LIFELINE™ STEMI SYSTEMS ACCELERATOR

Case 1 65 y/o female with sudden onset of sub-sternal chest pain at 11PM EMS called. On arrival offers to transport to non-PCI capable facility 30 minutes away. Husband declines and drives patient to free standing ED On arrival 11:36 pt ECG c/w acute inferior STEMI ED physician notifies cardio-hospitalist, transmits ECG, while the patient is being loaded for transport

ECG on arrival to ED

Hospital Course Pt arrived to PCI capable facility at 12:20 and taken directly to cath lab Initial balloon inflation at 12:38 D2B from ED 62 minutes Total ischemic time 98 minutes

Cardiac Cath

Cardiac Cath

Cardiac Cath

Points of discussion Should EMS have even offered to go to a non- PCI capable facility? Should lytics have been given prior to transport? Would an EMS on site ECG changed the course or even expedited the care?