Question#: 546

Question:

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?

Answer:

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.