Related Experiment Video
Updated: Sep 16, 2025
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
22.0K
Rural Outreach: Door to Thrombolytics
Sarah A Herrera1, Janet L Tuttle1
1Intermountain Health, St. Mary's Regional Hospital, Grand Junction, Colorado, USA.
JACC. Case Reports
|July 4, 2025
Summary
A new transfer protocol significantly reduced treatment times for ST-segment elevation myocardial infarction (STEMI) patients transferred from rural facilities. Door-to-thrombolytic administration time decreased by 71%, improving care for critical cardiac events.
Area of Science:
- Cardiology
- Emergency Medicine
- Healthcare Systems
Background:
- St. Mary's Regional Hospital (SMRH) serves a vast rural area, with 45% of ST-segment elevation myocardial infarction (STEMI) cases originating from transfers.
- Facility A, a rural Colorado hospital, relies on SMRH for advanced care and uses thrombolytics as first-line STEMI treatment due to limited cath lab access.
Observation:
- Facility A experienced a prolonged average door-to-thrombolytic administration time of 79.5 minutes for STEMI patients.
- This extended time for STEMI treatment at Facility A, a major transfer source for SMRH, prompted an investigation.
Findings:
- SMRH cardiology team developed and implemented a new transfer protocol to streamline STEMI treatment processes.
- Following protocol implementation, door-to-thrombolytic administration times at Facility A were reduced by 71% within 18 months.
Implications:
- The new protocol significantly decreased STEMI treatment delays, achieving a 2024 year-end average of 23 minutes.
- This initiative demonstrates the effectiveness of standardized transfer protocols in improving time-sensitive cardiac care for rural populations.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
26
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
26
01:30Venous Thrombosis IV: Nursing Management
25
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
25
01:27Peripheral Artery Disease III: Interprofessional Care
32
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
32
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
46
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
46
01:16Clot Retraction and Fibrinolysis
6.9K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
6.9K
01:23Atherosclerosis IV: Nursing Management
59
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
59