Provider Training Module Written Tutorial
Introduction
- 1.1: The Project UPSTART Provider Education Tutorial
- 1.2: What exactly is STEMI?
- 1.3: STEMI treatment: The theory behind the “need for speed”
- 1.4: Treatment of STEMI
- 1.5: What exactly is “Project UPSTART”?
- 1.6: The four keys to STEMI identification and management
- 1.7: Recognition: the first Key Step
- 1.8: The STEMI ALERT Packet: The Trigger for Reperfusion
- 1.9: Inside the STEMI ALERT Packet
- 1.10: Individual roles of the STEMI care team
- 1.11: Completing Data Sheets A & B
- 1.12: Data Sheets A and B: The Key to Continued Success
- 1.13: STEMI ALERT Data Management: Put That Data to Work!
- 1.14: A final review of the four keys steps
Training Tutorial 1.7
Recognition: the first Key Step
To treat a STEMI, you must first detect it, right?
But “only an ECG that’s done” can detect
a STEMI. That seems obvious. But no ECG gets done by itself and the ED is always a busy place. In addition, patients presenting with STEMI often have “atypical” symptoms, so history and physical exam really aren’t that helpful. This combination is a potential disaster as we are often tempted to “skip just this one ECG!”
To help solve this problem, the “UPSTART Screening ECG Protocol” has been designed (figure 6). Please review carefully. Look familiar? It will soon be displayed in your emergency department. Always obtain screening ECGs on patients that fit its criteria, even if you think they don’t need it. Sooner or later, you will have a patient who appears to be fine, but with an ECG that tells you otherwise.
Consistently obtaining screening ECGs is one of the most critical parts of the entire process. It’s your only defense against a missed STEMI and a possible disastrous outcome! It’s an underappreciated, but heavy responsibility.
Remember: When in doubt, do the ECG! Never rely on your clinical “guestimation” to determine who is having a STEMI.