Emergency Interhospital Transfer of Patients With ST-Segment-Elevation Myocardial Infarction: Call 9-1-1-The American Heart Association Mission: Lifeline Program

Abstract

The American Heart Association Mission: Lifeline program objectives are to improve the quality of care and outcomes for patients with ST-segment-elevation myocardial infarction. Every minute of delay in treatment adversely affects 1-year mortality. Transfer of patients safely and timely to hospitals with primary percutaneous coronary intervention capability is needed to improve outcomes. But treatment times continue to show delays, especially during interhospital transfers. A simple 3-step process of an interhospital "Call 9-1-1" protocol may expedite this process. This STAT TRANSFER process uses a systems approach that considers diverse ways in which patients access care, how EMS responds and determines destinations, how referring hospital transfers are performed, urban and rural differences, and how receiving hospitals prepare for an incoming patient with ST-segment-elevation myocardial infarction. This initiative suggests a strategy to reduce variability in interhospital transfer times using a STAT TRANSFER and a Call 9-1-1 process in a system of care that involves all stakeholders.

Keywords: Call 9‐1‐1; STAT TRANSFER; STEMI; acute myocardial infarction.

Figure 1. Guidance for transport of a patient with potential STEMI by EMS.

EMS indicates emergency medical services; FMC, first medical contact; PCI, percutaneous coronary intervention; SRC, STEMI receiving center; and STEMI, ST‐segment–elevation myocardial infarction.

Figure 2. Guidance for transport of a walk‐in or self‐transported patient with STEMI.

EMS indicates emergency medical services; FMC, first medical contact; PCI, percutaneous coronary intervention; SRC, STEMI receiving center; and STEMI, ST‐segment–elevation myocardial infarction.