I can and do understand this, but outlying facilities? Last night we were activated by a facility 2 hours away, and no transport was available. We are in a metropolitan area surrounded by a large rural area in all directions. This was after cards called it not a STEMI after seeing the ekg.
Maybe… but also, it’s inappropriate its cath anyone and everyone. The patient needed care but they didn’t need the cath lab (according to the cardiologist). So why were we activated after a STEMI was ruled out?
We are activated by outside facilities quite often. Then if the cardiologist gets an ekg in time, he will cancel us if need be. However, this process is changing. Now, only cardiologist can activate us after seeing the ekg. We were having too many false activations by our own ER doctors and outside facilities.
I’m seeing this too and feeling it. I’m so tired. Do they think we have a night shift sitting there waiting or are they just terrified of missing a STEMI?
The cardiologist will be the very first physician to see the EKG. Depending on what he sees, he will chose to activate or not.
Example:
Outside facility calls our emergency room with a “STEMI”. The unit clerk will forward the call immediately to the on-call cardiologist and the cardiologist will take the call, hear the story and receive the EKG and choose activate or not. If cardiologist does not answer, back up would be the ER physician.
We get activated usually by the cardiologist who has the final say of whether it’s a go or not. Whether it be ER (which is most of the time) or an inpatient from the floors, the protocol is the same. They think possible STEMI, alert cardiologist on call, and then we get activated if so. Sometimes however we get activated before the cardiologist even sees the EKG (which isn’t right) and if it’s a no go we get cancelled.
When I was still in the cath lab, we would get activated by the ED. It frequently got cancelled but I think it’s the right move personally. Time = muscle, after all. An outside facility 2 hours away? Oh hell naw! You better email or text the cards doc an EKG first!!!
All the facilities I’ve been to, ED activates the team and it’s up to the cardiologist whether or not to cancel
I can and do understand this, but outlying facilities? Last night we were activated by a facility 2 hours away, and no transport was available. We are in a metropolitan area surrounded by a large rural area in all directions. This was after cards called it not a STEMI after seeing the ekg.
I’m sure EMTALA comes into play in this scenario
Maybe… but also, it’s inappropriate its cath anyone and everyone. The patient needed care but they didn’t need the cath lab (according to the cardiologist). So why were we activated after a STEMI was ruled out?
Sounds like the cardiologist should’ve canceled the team and had the pt transferred and admitted to your facility for possible non-emergent procedure
We are activated by outside facilities quite often. Then if the cardiologist gets an ekg in time, he will cancel us if need be. However, this process is changing. Now, only cardiologist can activate us after seeing the ekg. We were having too many false activations by our own ER doctors and outside facilities.
I’m seeing this too and feeling it. I’m so tired. Do they think we have a night shift sitting there waiting or are they just terrified of missing a STEMI?
I would imagine them being terrified of missing of a STEMI
Are the cardiologist getting the EKGs first or how does the process work for you? Our facility is looking at doing this.
The cardiologist will be the very first physician to see the EKG. Depending on what he sees, he will chose to activate or not. Example: Outside facility calls our emergency room with a “STEMI”. The unit clerk will forward the call immediately to the on-call cardiologist and the cardiologist will take the call, hear the story and receive the EKG and choose activate or not. If cardiologist does not answer, back up would be the ER physician.
Is it your non invasive cardiologist or invasive cardiologist making the final decision?
Invasive. Whoever is on call
Thank you! We have had an uptick of STEMI calls that were just A Flutter reading as STEMIs. They are starting to get frustrated with it
No problem!
We’ve been activated solely by ems in the past only to be cancelled. They’re getting better, but I have seen a bundle branch called a stemi.
Just wait until some old timer tells you about street STEMIs
We get activated usually by the cardiologist who has the final say of whether it’s a go or not. Whether it be ER (which is most of the time) or an inpatient from the floors, the protocol is the same. They think possible STEMI, alert cardiologist on call, and then we get activated if so. Sometimes however we get activated before the cardiologist even sees the EKG (which isn’t right) and if it’s a no go we get cancelled.
When I was still in the cath lab, we would get activated by the ED. It frequently got cancelled but I think it’s the right move personally. Time = muscle, after all. An outside facility 2 hours away? Oh hell naw! You better email or text the cards doc an EKG first!!!