In 2006, Eisenhower Medical Center was only the fourth hospital in California accredited as a Chest Pain Center by the Society of Chest Pain Centers. Chest Pain Centers strive to quickly diagnose cardiac patients, begin treatment within minutes and significantly improve the chance of a positive outcome. Much of the criteria required by the Society of Chest Pain Centers and met by Eisenhower Medical Center positioned the hospital to become an approved STEMI Receiving Center.
The American College of Cardiology, American Heart Association and the Society for Cardiovascular Angiography and Interventions recommend a “door-to-balloon” time (interval between the patient’s arrival at the hospital and the opening of the blocked blood vessel by percutaneous coronary intervention, or PCI) of 90 minutes or less. According to the National Institutes of Health, the speed with which PCI for heart attacks is provided can mean the difference between life and death, health and disability. Studies show that Chest Pain Centers, like Eisenhower Medical Center, increase survival rates by 65 percent.
Christine Craig, RN, who has been Clinical Director for Eisenhower Medical Center’s Emergency Services for five years, says while speed is critical in addressing heart patients, the STEMI designation is important for the patient’s outcome because of the comprehensive treatment staff can provide at a STEMI designated Center versus a non-designated center. “At Eisenhower, we can take multiple steps to help the patient — from the first steps in caring for a patient with chest pain by recognizing symptoms and getting an EKG, involving the cardiologists and doing preliminary tests, to providing interventional care for the patient who requires it, whether that requires a cardiac cath lab diagnostic visit, having a stent surgically implanted, or even open heart surgery,” says Craig.
The STEMI Receiving Center designation also gives the county’s Emergency Medical Services (EMS) personnel the opportunity to contact the hospital in advance of the patient’s arrival at the hospital. EMS systems are integrated with the hospital to establish a patient’s pre-hospital history, perform an electrocardiogram prior to the patient’s arrival at the hospital and notify Eisenhower Medical Center that the patient is en route and will require STEMI services. This integration of services allows for quicker, more efficient treatment of a patient experiencing chest pain to reduce the risk of death or permanent damage to the heart.
Eisenhower achieved certification as a STEMI Receiving Center after an extensive review by the Riverside County Emergency Medical Services Agency. Certification requirements included operating a cardiac catheterization laboratory licensed by the Department of Health Services and approved for emergency PCI — a surgical procedure that opens narrowed or obstructed blood vessels by inflating a small balloon and inserting a wire mesh tube called a stent that keeps the blood vessel open. In addition, a STEMI Receiving Center must provide a nursing director for the center, have an on-call physician consultant who must be available promptly, and have a cardiologist with primary PCI privileges. This team of nurses, cardiologists, cardiovascular surgeons and electrophysiologists must be available 24 hours a day, seven days a week, for a hospital to be designated a STEMI Receiving Center.