Level One Program: Heart Attack Protocol
The Mississippi Heart Institute initiated a Level I Heart Attack Protocol to decrease "door to balloon" (D2B) time for acute myocardial infarction (MI) patients. Our streamlined process begins even before your patient arrives in our Emergency Department.
St. Dominic's was ranked #1 in cardiac services among all Mississippi hospitals by HealthGrades in 2008, with recognition as a center of clinical excellence for care of patients with acute MI, heart failure, interventional and cardiovascular surgery procedures.
Rapid Team Development
EKGs can be transmitted to St. Dominic's Emergency Department for rapid physician interpretation. If ST Elevation MI (STEMI) is apparent, a lateral page is sent to St. Dominic's Cath Lab team. An interventional cardiologist is simultaneously contacted, and by the time your patient arrives at St. Dominic's, our team is ready to directly admit your patient to the Cath Lab for an emergency cardiac catheterization and coronary intervention, if necessary.
Door to Balloon Time
Our mean D2B time has consistently been below the 90 minute CMS standard. Our goal is to reduce YOUR patient's D2B time. Since time is muscle, it's imperative we continue to develop processes to preserve myocardium for patients who are in our extended community.
Mission of Service
Our heart patients and their loved ones expect not only the best technology, but an atmosphere of hope for a positive outcome. St. Dominic's meets those expectations and more with an attitude of service and compassion like none other in our area. Thank you for partnering with St. Dominic's care-giving team.
Heart Attack Protocol
Criteria:
ST Elevation Myocardial Infarction (MI)
with onset of symptoms less than 12 hours
- Activate team
- Monitor, Oxygen, IV with saline
- Aspirin - 81 mg (give 4 chewable - even if patient already took an aspirin that day)
- Clopidogrel (Plavix) 600 mg PO* (* If patient take Plavix, lower to 300 mg PO.)
- Nitroglycerin 0.4 mg SL (repeat as needed or IV)
- Heparin: loading dose of 60 units/kg IV (4,000 units max)
- Beta Blocker: Metroprolol 25 mg PO (5mg IV q 5 minutes x 3 if unable to take PO)
- Chest X-ray - portable if time permits
- Morphine Sulfate as needed for pain
- Second IV saline locked
- Attach hands-free defibrillator pads
- In-the-door to out-the-door goal is less than 30 minutes
This information is intended only as a guideline. Please use your best judgment in the treatment of patients.
To alert the Level 1 Heart Attack team, call 601-200-2111.
