1. Chattanooga/Tristate Region STEMI Update 2014 C. Samuel Ledford, MD Chattanooga Heart Institute

2. Disclosures None relevant to this talk

4. Whitfield Murray Georgi a Tenne ssee

7. The Realities of Transport/Communication in our Tristate Region Weather Topography Limited Resources

8. How do we increase the number of patients with timely access to reperfusion therapy?

9. We Know what the problems are. So what do we do? Concept: A Regional STEMI Taskforce

10. Barriers to Timely Reperfusion The Patient Hesitation to seek medical attention Transported to E.D. by private vehicle Time to transport/EMS Delivery to the closest hospital by EMS, regardless of PCI capabilities Long transport in rural areas Limited Resources STEMI Referral Hospitals Reticence to use Thrombolytics Delay in Transfer to PCI facility STEMI Receiving Hospitals Multiple Thrombolytic and transport protocols

11. Tri-State Regional STEMI Taskforce Charter Mission Statement: The mission of the Tri-State Regional STEMI Taskforce is to improve the quality of care and outcomes in acute coronary syndrome patients through a uniform readiness and response to ST-Elevated Myocardial Infarction (STEMI) patients. Purpose: The Tri-State Regional STEMI Taskforce is a multi-disciplinary, multi-organizational group of healthcare providers focused on decreasing the time to reperfusion therapy, reducing inefficiencies, optimizing resources for patients with ST- Elevated Myocardial Infarctions, and caring for the patent with acute coronary syndrome.

12. STEMI Receiving Hospitals/ Local Government Letters of Support for a Regional STEMI Task Force Financial Commitment to support Task Force Membership on Executive Committee of Southeast Tennessee Regional Medical Communications Center (Region 3)

13. EMS/Helicopter Services Provide Educational Resources to EMS providers Use and transmission of 12-lead ECGs 12 Lead STEMI interpretation Empower EMS to diagnose STEMI in the field Develop Standardized EMS STEMI protocols Develop Alternative options for Counties without automated 12 Lead transmission capabilities. Create Feedback documents for EMS

15. STEMI-Referral Hospitals Provide Educational support to ED’s Create Standardized STEMI Medical Treatment Protocols Create Standardized Thrombolytic Protocols Create Standardized Transport Protocols (EMS protocols) Rapid feedback with phone follow-up to ED and Feedback document

16. Begin to Think Inside The Box

17. Questions ?? STEMI Coordinators: Marla Thomas RN– Erlanger (423) 778-5673 Dee Dee Edgemon RN– Memorial (423) 495-7686 Sandra Tilley RN– Parkridge (423) 493-1589

18. Ten- one minute time savers are easier to recognize and implement than One – ten minute time saver