Where does the 90 minutes of the D2B time go?
The STEMI receiving center process begins with a call from EMS to the ED, informing the ED that they are bringing a STEMI patient. The ED activates the cath lab by calling the hospital operator. The operator pages the cath lab call team and everybody heads into the hospital. At this time, most hospitals do not have in-house cath lab call teams. In the ED, the ECG is confirmed as a STEMI, and ED nurses proceed to evaluate the patient, begin ECG and pressure monitoring, insert another IV line and administer medications as needed. Stabilization and documentation consume most of their time. In our system in years past, there was a delay caused by prolonged ED evaluation, with a hold-up of transfer by nurses completing their notes before moving the patient upstairs. This is no longer the case and in fact, this was one of the two changes that dramatically shortened patient time in the ED. The first remedy was to institute a “no-hold” in the ED for any reason once the cath lab was ready. Givi
