Question#: 546
In regards to STEMI bypass, if you have a patient who is initially VSA and then obtain a ROSC, then discover a STEMI upon 12 lead interpretation.... do you proceed to the nearest PCI or do you proceed to your nearest hospital?
Follow the STEMI Hospital Bypass Protocol. Proceed to either the PCI center or other appropriate hospital based on the criteria of the bypass protocol.
The BLS Chest Pain (Non-Traumatic) Standard states, under the STEMI Hospital Bypass Protocol, that:
* (5) Upon arrival at the PCI centre ... provide the following information to the PCI centre staff: ... (b) time of ROSC, if applicable; and
* If the ECG becomes STEMI-positive en route to a non-PCI destination, the patient should still be evaluated under this STEMI Hospital Bypass Protocol.
Therefore the standard implies that patients who present with STEMI post ROSC should be taken to a PCI center if they meet the other criteria.