News | Cath Lab | February 22, 2017

New Coordinated Heart Attack Care System Aims to Decrease Treatment Delays, Save Lives

Protocol enables paramedics to bypass the local emergency department and transport heart attack patients directly to a hospital

coordinated heart attack care, Ontario STEMI Bypass Protocol, Canada

February 22, 2017 — Two new Ontario-wide heart attack protocols for paramedic services and emergency departments that aim to saves lives went into effect February 1.

For patients experiencing chest pain who call 911, the Ontario ST Elevation Myocardial Infarction (STEMI) Bypass Protocol enables paramedic services to bypass the local emergency department and transport patients having a STEMI heart attack directly to a hospital that can open the blocked coronary artery and provide a primary intervention. STEMI is a form of a heart attack that can cause death if not treated within minutes.

In Ontario, the frequency of STEMIs is approximately 68 of every 100,000 adult residents, a total of about 7,000 STEMIs per year. Timely reperfusion (the opening of a blocked coronary artery) requires early diagnosis via an electrocardiogram (ECG) and transportation to an advanced cardiac hospital via paramedics.

"Calling 911 means quicker treatment because paramedics are trained to recognize heart attack symptoms," said Madhu Natarajan, M.D., chair, Ontario STEMI Network, director, cardiac cath lab Hamilton; professor of medicine, cardiology at McMaster University, Interventional Cardiology, Hamilton Health Sciences. "[They] can begin treatment and call ahead to the emergency department and take you to the right place at the right time."

Any heart attack treatment begins with paramedics who have the medical expertise to complete an assessment and perform an ECG to determine if patients are having a STEMI heart attack. With the new protocol, paramedics can bypass the local hospital and transport directly to an advanced cardiac hospital where an interventional cardiologist can restore blood flow to the blocked coronary artery.

"When individuals experience symptoms of a heart attack (i.e. chest/arm pain, nausea, sweating and shortness of breath) it is very important that they call 911," said Peter F. Dundas, chief, Peel Regional Paramedic Services, Ontario Association of Paramedic Chiefs. "The Emergency Department STEMI Protocol ensures standardized, best-practice care for all STEMI patients in Ontario."

All emergency departments (ED) in Ontario now utilize a standard STEMI ED protocol when caring for patients experiencing a STEMI heart attack. Educational tools and resources have been distributed to every Emergency Department in Ontario to support implementation of the protocol.

The protocols also include standard care algorithms for patients that reside in remote regions.

The STEMI Protocols were developed in consultation with the Cardiac Care Network (CCN), the Ontario Association of Paramedic Chiefs, the Ontario Base Hospital Group Executive Committee, the Ontario Base Hospital Group Medical Advisory Committee, Toronto Paramedic Services and Ornge.

The CCN, under the direction of the Provincial Programs Branch (PPB), took the lead on the development of the Ontario STEMI Bypass Protocol through their Ontario STEMI Network, which included cardiologists, hospital administrators, base hospital medical directors and paramedics from across the province.

In Canada, there is a death every seven minutes due to heart disease or stroke. In 2008, myocardial infarctions (MI) made up 23 percent of deaths related to cardiovascular disease. Most deaths caused by myocardial infarctions occur out-of-hospital.

For more information: www.ccn.on.ca

Related Content

The Current Direction of Healthcare Reform Explained by CMS Administrator Seema Verma
News | Cardiovascular Business | June 11, 2019
Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma addressed the American Medical Association (...
DAIC Earns Azbee National Bronze Award for Social Media Presence
News | Cardiovascular Business | May 10, 2019
May 10, 2019 — Diagnostic and Interventional Cardiology (DAIC) earned a Bronze Award at the 2019 Na
Cath lab staff working as a team to prepare for a procedure at Presbyterian Medical Center Cardiac Cath Lab, Charlotte N.C. Pictured are Barry Horsey RCIS, Emily Luna RN, RCIS, Adam Martin RCIS, Caleadia Jessup RN.

Cath lab staff working as a team to prepare for a procedure at Presbyterian Medical Center Cardiac Cath Lab, Charlotte N.C. Pictured are Barry Horsey RCIS, Emily Luna, RN, RCIS, Adam Martin, RCIS, Caleadia Jessup, RN.

Feature | Cardiovascular Business | May 03, 2019 | Ruben Filimonczuk, RCES, AS-PMD
One of the most promising areas for innovation in healthcare is to be found in the workforce – both in hiring and ret
Fail-safe Program for New Medical Technology Focuses on Patient Safety
News | Cardiovascular Business | April 29, 2019
New medical technology offers the promise of improving patient care, as well as the potential for harm if caregivers...
Medicare Trustees Report Hospital Insurance Trust Fund Will Deplete in Seven Years
News | Cardiovascular Business | April 22, 2019
The Medicare Hospital Insurance (HI) Trust Fund, which funds Medicare Part A, will only be able to pay full benefits...
Videos | Cardiovascular Business | April 16, 2019
A discussion with Ruth Fisher, MBA, vice president of the...
Foreign-trained doctors now make up one-third of cardiologists in the United States and help make up for the U.S. overall shortage of physicians. Pictured here is co-author of this article Mandeep R. Mehra, MBBS, MSc, FRCP, who is an example of the contribution international physicians have made in the U.S. He is medical director of the Brigham and Women’s Hospital Heart and Vascular Center.

Foreign-trained doctors now make up one-third of cardiologists in the United States and help make up for the overall shortage of physicians. Pictured here is co-author of this article Mandeep R. Mehra, MBBS, MSc, FRCP, who is an example of the contribution international physicians have made in the U.S. He is medical director of the Brigham and Women’s Hospital Heart and Vascular Center, The William Harvey Distinguished Chair in Advanced Cardiovascular Medicine, and a professor of medicine at Harvard Medical School. He is past-president of both the Heart Failure Society of America and the International Society of Heart and Lung Transplantation. 

Feature | Cardiovascular Business | April 15, 2019 | William W. Pinsky, M.D., FAAP, FACC, and Mandeep R. Mehra, MBBS, MSc , FRCP
As we strive to process today’s successive news cycles involving negative reports about immigration, it is easy for m
ACC Combines NCDR, Accreditation Into New Quality Summit
News | Cardiovascular Business | March 15, 2019
The American College of Cardiology’s first annual ACC Quality Summit, held March 13-15 in New Orleans, merges the NCDR...
Diagnostic and Interventional Cardiology Named 2019 Azbee Awards Finalist for Social Media
News | Cardiovascular Business | March 08, 2019 | Jeff Zagoudis, Associate Editor
Diagnostic and Interventional Cardiology (DAIC) was named a finalist in the Social Media Presence category for the 2019...
Overlay Init