Pre-hospital treatment of STEMI patients. A scientific statement of the Working Group Acute Cardiac Care of the European Society of Cardiology

M. Tubaro, N. Danchin, P. Goldstein, G. Filippatos, Y. Hasin, M. Heras, P. Jansky, T. M. Norekval, E. Swahn, K. Thygesen, C. Vrints, D. Zahger, H. R. Arntz, A. Bellou, J. E. De La Coussaye, L. De Luca, K. Huber, Y. Lambert, M. Lettino, B. LindahlS. Mclean, L. Nibbe, W. F. Peacock, S. Price, T. Quinn, C. Spaulding, G. Tatu-Chitoiu, F. Van De Werf

    Research output: Contribution to journalArticlepeer-review

    41 Scopus citations

    Abstract

    In ST-elevation myocardial infarction (STEMI) the pre-hospital phase is the most critical, as the administration of the most appropriate treatment in a timely manner is instrumental for mortality reduction. STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service are pivotal. The first steps are devoted to minimize the patient's delay in seeking care, rapidly dispatch a properly staffed and equipped ambulance to make the diagnosis on scene, deliver initial drug therapy and transport the patient to the most appropriate (not necessarily the closest) cardiac facility. Primary PCI is the treatment of choice, but thrombolysis followed by coronary angiography and possibly PCI is a valid alternative, according to patient's baseline risk, time from symptoms onset and primary PCI-related delay. Paramedics and nurses have an important role in pre-hospital STEMI care and their empowerment is essential to increase the effectiveness of the system. Strong cooperation between cardiologists and emergency medicine doctors is mandatory for optimal pre-hospital STEMI care. Scientific societies have an important role in guideline implementation as well as in developing quality indicators and performance measures; health care professionals must overcome existing barriers to optimal care together with political and administrative decision makers.

    Original languageEnglish
    Pages (from-to)56-67
    Number of pages12
    JournalAcute Cardiac Care
    Volume13
    Issue number2
    DOIs
    StatePublished - 1 Jun 2011

    Keywords

    • ambulance
    • emergency medical service
    • nurses
    • paramedics
    • pre-hospital
    • primary coronary angioplasty
    • reperfusion
    • ST-elevation myocardial infarction
    • systems of care
    • thrombolysis

    ASJC Scopus subject areas

    • Emergency Medicine
    • Radiology Nuclear Medicine and imaging
    • Cardiology and Cardiovascular Medicine

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