2022 Quality Summit ePosters (Non-CE) - Chest Pain-MI Registry-6. Improving Accuracy in the ED STEMI Activation Process (Reducing Cancellations)

6. Improving Accuracy in the ED STEMI Activation Process (Reducing Cancellations)

Pdf Summary

The study aims to reduce unnecessary activations and subsequent cancellations of the STEMI cath lab in a tertiary care emergency department (ED) without compromising accuracy. The authors emphasize the importance of early activation of the cath lab team to achieve shorter door-to-balloon times. Currently, EDs and EMS often activate the cath lab to prevent delays, leading to more unnecessary activations and cancellations. To address this issue, several mechanisms were implemented, including monthly combined meetings between the emergency department and the interventional cardiology sub-section.<br /><br />The study reviewed every cancelled STEMI activation from the ED and EMS, analyzing reasons for activation, reasons for cancellation, subsequent treatment plans, and outcomes. With interventions, ED STEMI activation cancellations decreased from 40% to 16%. However, EMS cancellations only decreased from 62% to 55% over a 12-month period. Total activations per month remained unchanged, and no complications were reported from cancelled activations. The last month tracked showed 15 ED activations with no cancellations, indicating the success of educational interventions.<br /><br />The study concludes that implementing these interventions can reduce unnecessary STEMI activations and subsequent cancellations. However, no relevant disclosures were provided for the study authors. The references acknowledge a study conducted by Lange DC and colleagues on cancelling the cardiac catheterization lab after activation for ST-segment-elevation myocardial infarction. The authors also thank the department of quality at Baylor Scott & White Heart and Vascular Hospital – Dallas and their partners in the Emergency Department. One example of a cancelled activation was provided, where the cancellation was attributed to no chest pain. The patient was admitted for a urinary tract infection, kidney infection, and gastrointestinal bleed.

Keywords

STEMI cath lab

reducing activations

cancellations

tertiary care emergency department

early activation

door-to-balloon times

EMS

interventional cardiology

cancelled activations