Code STEMI may not have the same catchy ring as “Code Red” or “Code Blue” that you often hear shouted on your favorite television hospital show. But in the real world of health care those two words set a lifesaving process into motion at New Hanover Regional Medical Center.
Code STEMI is an alert system that brings together medical professionals across the hospital to treat a patient who is having a ST-Segment–Elevation Myocardial Infarction – a severe heart attack caused by the total blockage of an artery.
Whether it’s a patient transported to New Hanover Regional Medical Center by ambulance, or someone suffering chest pain and driven to the hospital by a friend or family member, once the Emergency Room physician diagnoses the condition through an electrocardiogram, the Code STEMI alert notifies an entire team to prepare the Cardiac Catheterization Lab for a lifesaving procedure.
The goal is to have the procedure done within 90 minutes of the patient entering the hospital. In hospital terminology it’s called “door-to-balloon time”, reflecting the balloon-like angioplasty procedure done on many patients to open the blocked artery.
“Research data shows patients have better outcomes when they receive PCI (Percutaneous Coronary Intervention) in 90 minutes or less,” said Janet DeLucca, Manager of NHRMC’s Cardiac Cath Lab. “The Code STEMI initiative helped focus our efforts and brought much more consistency to our results, and that’s better for our patients.”
In July 2006, the American College of Cardiologists and the American Heart Association set a goal to reduce the door-to-balloon time from less than 120 minutes to less than 90 minutes. The Centers for Medicare and Medicaid and the Joint Commission on Accreditation of Hospital Organizations followed suit, making 90 minutes the national standard. Experts say meeting this goal saves damage to the heart, decreasing the number of patients permanently disabled from heart disease.
Since NHRMC adopted the Code STEMI protocol in July of 2006, the average door-to-balloon time for heart attack patients has dropped to just over 76 minutes, well ahead of the national standard set by those leading organizations. It is also faster than the national average of 92 minutes reported by leading centers across the country in a 2007 update by the American College of Cardiologists.
“That’s impressive on a national scale,” said Dr. Martin Conley, Wilmington Cardiologist who chairs the Outcomes Committee of NHRMC’s Department of Cardiology and also serves on the committee that reviews the hospital’s Code STEMI protocol. “This is one of the brightest points at our hospital. The fact that people from different disciplines are committed to this initiative and invested in bringing about good outcomes for our patients is wonderful.”
The multi-disciplinary team meets regularly to study all of the Code STEMI cases and look for ways to improve the response time. Each step in the system is benchmarked, from the time it takes to administer the electrocardiogram in the emergency room, to the arrival of the on-call cardiologist and cardiac interventionalist, to completion of the procedure that clears the blocked artery.
Shaving a minute off the process is beneficial, since time is muscle when dealing with the heart.
“It can mean the difference between a patient having a long, difficult recovery from a heart attack, and a patient who returns home to a fairly normal life,” said DeLucca.If you would like to speak to a physician about heart disease or symptoms you may be having, please call VitaLine for a referral 815.5188.To learn more about heart attacks click here.