Streamlined Emergency Response

MyMichigan Medical Center Emergency Medical Services (EMS) and MyMichigan Health have implemented Regional STEMI Alert Programs at MyMichigan Medical Centers in Alpena and Midland to rapidly identify patients who are suffering from ST segment elevation myocardial infarction (STEMI), the most serious type of heart attack. In STEMI patients, the coronary artery is completely blocked off by a blood clot. As a result of this blockage, all of the heart muscle being supplied by the affected artery starts to die.

The specialized program is designed to train paramedics on how to perform and read a 12-lead electrocardiogram (ECG) to quickly identify STEMI patients at the scene. They can then implement lifesaving protocols to bypass the closest Emergency Department (ER) and take the patient to the nearest Percutaneous Coronary Intervention (PCI) Center. Upon arrival, the patient is taken directly to the cardiac catherization lab so that blood flow can be quickly reestablished to their heart. With state protocols now in place, MyMichigan’s STEMI Alert Program is approved for up to a 90-minute patient transport time to the nearest PCI Center. To ensure overall success of the program, MyMichigan Medical Center EMS actively collaborates with other local EMS agencies to provide training and share best practices.

STEMI Process

	Step 1 - Individual experiences one or more signs of a heart attack (chest pain, shortness of breath, dizziness, heavy sweating, indigestion or radiating pain) and dials 911
	Step 2 - Emergency Medical Services (EMS) personnel arrive at the scene and perform a 12-lead electrocardiogram (ECG) to determine the extent of the individual’s cardiac emergency
	Step 3 - For certain types of heart attacks, EMS personnel immediately contact the Emergency Department (ER) at the nearest Percutaneous Coronary Intervention (PCI) Center
	Step 4 - The ER staff quickly activate the Cardiac Cath Rapid Response Team and admit the patient to the Medical Center
	Step 5 - The ambulance arrives at the Medical Center, bypasses the ER and heads straight for the cardiac cath lab for immediate intervention to re-establish blood flow to the heart

Bypassing the ER and heading straight for the cath lab saves an average of 20 minutes or more, time that can be critical for a heart attack patient. MyMichigan Medical Centers in Alpena and Midland have set a target of <=90 minutes for door-to-balloon intervention based on recommendations by the American College of Cardiology. By following these recommendations, the patient’s chance of recovery without loss of heart muscle or long-term complications is very high.

This streamlined approach is also implemented in cases where a patient arrives in the ER and presents with heart attack symptoms. The patient is quickly moved into an exam room where a 12-lead ECG is performed to determine the extent of the cardiac emergency and the course of action. For patients arriving to the ER at a non-PCI medical center, the patient is diagnosed and given early treatment, then quickly transported to a PCI Center where the Cardiac Cath Rapid Response Team is ready to ensure expedited treatment upon arrival.

Don’t Wait, Don’t Drive, Dial 911

Community members are urged to not ignore the warning signs of a heart attack. The best way to prevent irreversible heart damage is to dial 911 immediately. Upon arrival, EMS personnel can begin treatment as soon as they arrive — up to an hour sooner than if someone goes to the hospital by car. EMS staff are also trained to provide resuscitation efforts to someone whose heart has stopped. Even if your symptoms end up pointing to a different medical problem, you’ll be in the right place for treatment. When it comes to a heart attack, time is muscle, and the first hour is critical for effective treatment.

Quality You Can Measure

• MyMichigan Medical Center EMS in Midland and Gladwin, in collaboration with MyMichigan’s Regional STEMI Alert Program partners, have received the American Heart Association’s Mission: Lifeline® EMS Gold Award for their commitment to offering rapid and research-based care to people experiencing the most severe form of heart attacks and strokes, ultimately saving lives. This is the ninth consecutive year MyMichigan has been recognized.
• MyMichigan Medical Center Midland was one of two hospitals in Michigan and 240 in the nation to receive the American College of Cardiology’s NCDR Chest Pain – MI Registry™ Performance Achievement Platinum Award. The award honors hospitals for their consistency in meeting patient care guidelines for heart attack patients.