RRTs are involved in STEMI response

(Editor's note: This is the second part of a two-part series on recent reaccreditation efforts made by the staff of the chest pain center at Oregon Health & Science University Hospital in Portland. In the first installment last month, the staff discussed the STEMI alert training procedures involved. These procedures not only involve the triage nurse, but the entire staff, including the valets. This month, we look at how the staff brought the hospital rapid response team into the process, and how the acquisition of atomic clocks enabled the ED and outside resources to accurately track their response times.)

During the recent reaccreditation process for the Oregon Health & Science University (OHSU) Hospital's Chest Pain Center, Mary Spiering, RN, MN, CNS, clinical nurse specialist for the cardiac service line, realized that "we really needed someone else" during ST-segment elevation myocardial infarction (STEMI) activation. Accordingly, Spiering got the hospital rapid response team involved.

"Now, during every STEMI activation, we have a respiratory therapist, cath lab interventional doctors, and the administrator on call," Spiering explains. "We trained them to not only pick up the patient, but to slap on the defibrillator. We found there were times they got there before the nurse could come or before the nurse got to the Pyxis machine."

Accordingly, she says, the rapid response team is now provided STEMI meds packets, which include aspirin, heparin, and other medications.

As another part of the reaccreditation process, about 35 atomic clocks were ordered and placed in the ED. "We wanted to make sure they were in every single room," explains Spiering. "When the clock starts for door-to-balloon time, we need precision time so we understand exactly when the patient arrived, when we did the EKG, and so on. Everything should all be timed on the same clock."

In the past, she notes, nurses would write down these events, and the timelines would sometimes conflict. "Time is always an issue," says Spiering, adding that OHSU's rural partner facilities also now have atomic clocks in their EDs. The clocks cost $123 each, says Spiering.


For more information on managing chest pain patients, contact:

  • Mary Spiering, RN, MN, CNS, Clinical Nurse Specialist, Cardiac Service Line, Oregon Health & Science University Hospital, Portland. Phone: (503) 494-8311.