EMS systems face a variety of barriers to achieving the ideal STEMI care practice.
However, there are solutions, as depicted in the chart below.
| BARRIERS | SOLUTIONS |
Lack resources: - Electrocardiogram (ECG) equipment
- Appropriate level of EMS provider
- Medical leadership
- Funding, particularly in rural or impoverished areas
| "Creative funding" - Multiple source grant writing
- County board of education
|
| Lack training to obtain 12-lead ECG and recognize STEMI | - STEMI training courses
- Case review
- Advocacy-change laws
|
| Lack of destination protocols | - Stakeholder STEMI steering agreement
- Buy-in from all entities
- Plan to implement
- Advocacy
|
No protocol for: - Pre-hospital diagnosis
- Advance notification
- Cath. Lab activation
- False activation
| - Meet with EMS director, hospital and/or medical leadership to establish protocol
- Monitor "appropriate activation"
|
| Transfer patients are second to 9-1-1 calls | - Change policy for transfer patients with STEMI to be viewed as 9-1-1
- Local, city, county and state advocacy
|
| Lack training on STEMI guidelines | - STEMI training course
- New STEMI chapter
|
| No existing link between EMS and PCI-capable hospital for data feedback | Establish data feedback for entire STEMI team |
