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Dripless Protocol to Reduce Air Ambulance Transport Times for STEMI Patients A Performance Improvement Protocol that Significantly Reduced Ground and Bedside Times. Sentara Heart Hospital Norfolk, VA Denise Baylous, MSN, RN-C, NREMT-P Kim Dawson, RN Carl Hartman, MD Brent Ibata, PhD JD MPH.
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Dripless Protocol to Reduce Air Ambulance Transport Times for STEMI PatientsA Performance Improvement Protocol that Significantly Reduced Ground and Bedside Times Sentara Heart Hospital Norfolk, VA Denise Baylous, MSN, RN-C, NREMT-P Kim Dawson, RN Carl Hartman, MD Brent Ibata, PhD JD MPH
Quick Facts • 800,000 people in the United States suffer an Acute Myocardial Infarction per year. • 250,000 die before presentation to the hospital • The survival rate for U.S. patients hospitalized with AMI is 90-95% • 50% of AMI’s in the U.S. occur in people younger than 65 years of age
Transport Obstacleswith STEMI Patients Interfacility • IV drips • No clear transfer process • Increase in ground time for flight crew
Goals Reduce transport time for all STEMI patients Increase standardized transfer elements for all patients diagnosed with STEMI. Streamline process.
Dripless STEMI Protocol • Referring Hospital • Activate STEMI transfer • Referring E.R. • Heparin bolus • Nitroglycerin paste • No I.V. drips • Receiving Hospital • Dispatch air ambulance • Activate STEMI team • Nightingale • Goal: Ground Time < 10 minutes
Dripless Protocol Impact on Bed Time • Bed Time: • 20.1 min before • 13.7 min after* * Outliers noted as circles
Dripless Protocol Impact on Ground Time • Ground Time: • 28.2 min before • 20.5 min after * Outliers noted as circles