Pre-hospital treatment of STEMI patients. A scientific statement of the Working Group Acute Cardiac Care of the European Society of Cardiology

Abstract

In ST-elevation myocardial infarction (STEMI) the pre-hospital phase is the most critical, as the administration of the most appropriate treatment in a timely manner is instrumental for mortality reduction. STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service are pivotal. The first steps are devoted to minimize the patient's delay in seeking care, rapidly dispatch a properly staffed and equipped ambulance to make the diagnosis on scene, deliver initial drug therapy and transport the patient to the most appropriate (not necessarily the closest) cardiac facility. Primary PCI is the treatment of choice, but thrombolysis followed by coronary angiography and possibly PCI is a valid alternative, according to patient's baseline risk, time from symptoms onset and primary PCI-related delay. Paramedics and nurses have an important role in pre-hospital STEMI care and their empowerment is essential to increase the effectiveness of the system. Strong cooperation between cardiologists and emergency medicine doctors is mandatory for optimal pre-hospital STEMI care. Scientific societies have an important role in guideline implementation as well as in developing quality indicators and performance measures; health care professionals must overcome existing barriers to optimal care together with political and administrative decision makers.

Keywords

Affiliated Institutions

• Poriya Medical Center IL
• KU Leuven BE
• Université de Lille FR
• Antwerp University Hospital BE
• Assistance Publique – Hôpitaux de Paris FR
• Aarhus University Hospital DK
• Haukeland University Hospital
• Charité - Universitätsmedizin Berlin DE
• Istituti di Ricovero e Cura a Carattere Scientifico IT
• Ospedale San Filippo Neri IT
• Hôpital Européen FR
• Policlinico San Matteo Fondazione IT
• European Hospital IT
• Wilhelminen Hospital AT
• Royal Brompton Hospital GB
• University Hospital in Motol CZ
• University of Vienna AT
• Cleveland Clinic US
• Hôpital Cochin FR
• Soroka Medical Center IL
• Hospital Clínic de Barcelona ES
• University of Antwerp BE
• Inserm FR
• University of Surrey GB
• Délégation Paris 5 FR
• Centre Hospitalier de Versailles FR
• NHS Forth Valley GB
• University General Hospital Attikon GR
• Uppsala University SE
• Université de Nîmes FR
• Hôpital Européen Georges-Pompidou FR

Related Publications