RACE June 09

Upcoming Events:
 
June 18
Non-PCI Center Emergency Department Leadership Meeting
 
 
Sept 11
NHRMC Cardiac Symposium
Holiday Inn Sunspree, Wrightsville Beach
 
 
Education Opportunities

Must Reads,
Recent Journal Articles: 

Intergration of
Pre-Hospital Electrocardiograms and ST-Elevation Myocardial Infarction Receiving Center (SRC) Networks: Impart on Door-to-Balloon Times Across 10 Independent Regions.
- J. Am. Coll. Cardiol. Intv. 2009;2;339-346
 
 

Specific RACE Goals:
 
System Goals
 
Direct Presenters to PCI Center:
1st Contact to balloon < 90 minutes
 
Patients who present to Non-PCI center:
1st Contact to balloon < 90 minutes
or if reperfused with lytics:
Door-to-lytic < 20 minutes

EMS Goals:

Scene time < 15 minutes
EMS arrival to balloon < 90 minutes
 
Non-PCI Center Goals:

Door to EKG < 10 minutes
Total time in ED < 30 minutes
 
Interfacility Transfer Goals:
At-hospital time < 10 minutes
 
Primary PCI center:

Door to EKG < 10 minutes for walk-ins
Total time in ED < 30 minutes

RACE Primary Goals:
To increase the RATE & SPEED of reperfusion.
Primary PCI < 90 Minutes
Or
Lytics < 30 Minutes
Steps for Success in RACE

EMS
Early Recognition of STEMI
Short Scene times, < 15 minutes
Early Notification to ED with STEMI Alert
Non-PCI Center EDs

Chest pain or Aginal Equivalent?
EKG < 10 Mins

Immediately Activate STEMI Hotline
1.877.NHSTEMI 
             647-8364

PCI possible in < 90 minutes: ASA, Heparin Bolus, limits drips if possible, prepare for transfer

PCI not possible < 90 minutes: ASA, lovenox, Lytic administration in < 30 minutes, prepare for transfer

Interfacility Transfer
At-hospital time of < 10 minutes
Limit use of IV drips if possible
PCI Center

Chest pain or Aginal Equivalent?
EKG < 10 Mins

Immediately Activate STEMI Hotline

Accept all patients regardless of bed availability

Cath team ready within 30 minutes of activation
Mission Lifeline
 
American Heart Association is working to implement the RACE program on a national scale in a program called Mission Lifeline.
New Hanover Regional Medical Center
Heart Center

NHRMC is the RACE PCI (percutaneous coronary intervention) Center for the South East RACE region. As a RACE PCI center, NHRMC must meet the following standards:
  1. Cath lab open 24/7 within 30 minutes
  2. STEMI team that meets regularly with STEMI leader.
  3. One-call activation system
  4. On-going data monitoring and feedback
  5. Accept STEMI patients regardless of bed availability
  6. Goal of improving care regardless of hospital affiliation
  7. On-site back up surgery