1. EMS: An Integrated Regional Systems Approach to Acute Events EMS: An Integrated Regional Systems Approach to Acute Events STROKE, TRAUMA,STEMI A FIVE MONTH REPORT SEAEMS JANUARY – MAY 2015

2. What is an integrated EMS regional system ?

3. IOM A coordinated, regionalized, accountable system.

4. STROKE 1/1/15 ---- 6/1/15

5. STROKE SYSTEM ENTRIES - ADJUSTED 1/1/15 — 6/1/15

6. STROKE TIME OF ONSET (EMS ARRIVAL ) 1/1/15-6/1/15

7. HOSPITAL REPORTS RECEIVED 1/1/15—6/1/15

8. HOSPITAL DIAGNOSIS 1/1/15– 6/1/15

9. HOSPITAL ADMISSION STATUS

10. TYPE OF STROKE 1/1/15--- 6/1/15

11. ALL ISCHEMIC TREATMENT

12. HEMORRHAGIC 2015 33.3% 2015 33.3% 2013 22.4% 2013 22.4% 2012 19.2% 2012 19.2% 2011 16.9% 2011 16.9% 2010 15.9% 2010 15.9% 2003 10.1% 2003 10.1% Why the climbing % of total strokes ? Why the climbing % of total strokes ?

13. STROKE HOSPITAL RED TIMES 1/15-5/15

14. CHALLENGES /OPPORTUNITES STROKE SYSTEM PATIENTS DIRECTLY TO SCANNER -- WHY NOT ?????? STROKE SYSTEM PATIENTS DIRECTLY TO SCANNER -- WHY NOT ??????

15. CT PERFORMED

16. ADDITIONAL CHALLENGES EMS Transfer Drug Course inclusion of LYTIC for stroke (BP CONTROL- ANAPHYLAXIS (EDEMA) Referring orders or ?, Lytic complete or still running, other concerns) EMS Transfer Drug Course inclusion of LYTIC for stroke (BP CONTROL- ANAPHYLAXIS (EDEMA) Referring orders or ?, Lytic complete or still running, other concerns) ATRIAL FIB. As a data point & measured /reported ATRIAL FIB. As a data point & measured /reported Hospital entries via email or text Hospital entries via email or text

17. TRAUMA 1/1/15--- 5/31/15

18. PATIENT DESTINATIONS 1/15- 5/15

19. ATS ENTRY COMPARISON

20. EMSP-DISCRETION ENTRY METHOD

21. EMSP-DISCRETION ADMITS

22. ALL ENTRIES ADMIT STATUS ( over-triage )

23. REGIONAL ADMITS/NON ADMITS MISSING HOSPITAL RECORDS 1/15– 5/15

24. TRAUMA HOSPITAL RED 1/15—5/15

25. STEMI SYSTEM PATIENTS 1/1/15—5/31/15 233 PATIENT ENTRIES 233 PATIENT ENTRIES 86 EMERGENTLY SENT TO THE Cath Table 86 EMERGENTLY SENT TO THE Cath Table 16 NOT ADMITTED (93%) 16 NOT ADMITTED (93%)

26. QUESTIONS ?????

27. WHAT CAN WE DO TO IMPROVE ATCC ?