Working Against the Clock: A Model for Rural STEMI Triage

Area of Science:

• Emergency Medicine
• Cardiology
• Rural Health

Background:

• Rural populations experience higher cardiac mortality rates.
• Delays in emergency care for ST-elevated myocardial infarction (STEMI) in rural areas increase mortality.
• Optimizing pre-hospital STEMI triage is essential for improving patient outcomes.

Purpose of the Study:

• To identify challenges impacting pre-hospital STEMI triage in rural U.S. communities.
• To explore emergency personnel perceptions of STEMI triage processes.
• To develop a model for improving rural STEMI care delivery.

Main Methods:

• Qualitative research design utilizing semi-structured interviews.
• Convenience sampling of 18 emergency personnel in rural Northeast Texas.
• Thematic analysis of interview data to identify key issues and opportunities.

Main Results:

• Pre-hospital STEMI triage efficiency is dependent on teamwork, technology, and training.
• Identified critical stages for improvement: pre-transport, door-to-door, and post-transport.
• A novel pre-hospital STEMI triage model was developed.

Conclusions:

• Implementing the proposed STEMI triage model can enhance care coordination in rural settings.
• Timely reperfusion therapy is more achievable with improved pre-hospital triage efficiencies.
• Addressing systemic factors can reduce STEMI mortality in high-risk rural populations.