Population of Interest

1. All patients presenting with a STEMI receive dual antiplatelet therapy, systemic anticoagulation and fibrinolytic therapy (unless contraindicated) within 30 minutes of arrival to a facility with these therapies available.
2. In facilities without fibrinolytics, dual antiplatelet therapy and systemic anticoagulation is administered before transfer to a higher level of care.

Intent (Expected Outcomes)

1. All patients with concern for STEMI or NSTEMI will have a documented consultation/teleconsultation with a cardiologist.
2. All patients diagnosed with STEMI are transferred to a PCI center.

Performance/Adherence Measures

1. Dual antiplatelet therapy and systemic anticoagulation are given within 30 minutes of arrival at a facility with these therapies available.
2. Fibrinolytic therapy is given within 30 minutes of confirmation of a STEMI in facilities that have these therapies, or door to PCI center within 120 minutes with facilities that can arrange for a transfer to a PCI center.
3. Consultation/teleconsultation with a cardiologist is documented for all patients with concern for STEMI or NSTEMI.

Data Source

- Patient Record
- Department of Defense Trauma Registry
- Theater Medical Data Store

System Reporting & Frequency

The above constitutes the minimum criteria for PI monitoring of this CPG. System reporting frequency will be performed annually; additional PI monitoring and system reporting may be performed as needed.

The system review and data analysis will be performed by the JTS Chief, Program Manager and PI Branch.

Responsibilities

It is the Chief of Trauma or equivalent’s responsibility to ensure familiarity, appropriate compliance and PI monitoring at the local level with this CPG.