Auxiliary Forms
These forms may easily be tailored to facilitate specific processes within the STEMI care continuum. Contact us at info@projectupstart.com for customizable Word templates.
- Criteria for ED Activation of the Cath Lab (.pdf)
- This is an easily adapted checklist for use in PCI institutions that utilize Emergency Department (ED) physician activation of the cath lab.
- Thrombolytics Guide Sheet (.pdf)
- Provides a quick access guide for helping the ED physician at non-PCI institutions assess a potential thrombolytic-eligible patient for reperfusion.
- EMS Guide Sheet (.pdf)
- Provides information and guidance for EMS providers, integrating them into the STEMI treatment pathway.
- Cath Lab Checklist (.pdf)
- Standardizing the sequence of key events necessary for consistent cath lab performance is a key to top-notch reperfusion times -- particularly on nights and weekends! This form can be easily customized to any cath lab.