Project UPSTART: the Use of Procedural Standardization to Reduce Recognition to Repferfusion (R2R) Time in ST-Elevation Myocardial Infarction (STEMI)

Training Tutorial 1.6

The Four Keys to STEMI Identification and Management

To help standardize your approach to STEMI management, we have condensed the day-to-day detection and management of STEMI into a simple process involving the four key steps depicted on this flowchart (figure 5). Please review them carefully! These actions are at the heart of success! They must become hardwired into the day-to-day flow of your emergency department.

The importance of these critical actions cannot be overstated. Sustained success in treating STEMI depends on these actions being repeated 24/7, every single shift of the year. If this doesn’t happen, sooner or later you will miss a STEMI or have a preventable delay. However, the reverse is also true: if you can do these four actions consistently, you can’t help but improve!

Remember this: Standardization and simplification reduce error. Doesn’t every pilot use a pre-flight checklist? Absolutely! They know that simple actions done the same way every time are the best way to avoid “simple” errors. And simple errors are usually the seeds of much larger errors!

Remember: The four key steps are the secret to success. Follow them 24/7.

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