Ten Minute Tracing (TMT) Project Update
In STEMI, the cornerstone of treatment is swift reperfusion. Even small delays in reperfusion time increases myocardial damage and its consequences. For example, mortality significantly increases with delays of as little as 10 minutes.
In suspected STEMI, the electrocardiogram (ECG) initiates reperfusion treatment. A timely ECG is key. Once a STEMI is identified by ECG, administration of fibrinolytic therapy or prompt transfer for percutaneous coronary intervention is critical. Guidelines recommend the time from first medical contact (FMC) to ECG (F2E) should be within 10 minutes if STEMI is suspected.
The MB ACS Network routinely analyzes F2E in all STEMI patients. Our monitoring data shows that recommended F2E times are mostly not achieved in Winnipeg emergency rooms (ER) or urgent care centres.
To achieve the recommended F2E times, several steps must be in place:
The staff first encountering a patient must be able to recognize common symptoms of STEMI and be empowered to request an urgent ECG.
The staff performing the ECG must be readily available.
The location for the ECG acquisition must be easily accessible.
The ECG must be immediately interpreted by a trained health care provider to confirm STEMI.
Working with the Grace General Hospital (GGH) ER, using these methods, GGH ER has had astounding success lowering F2E times in the last two years! Their median F2E times fell from 26 to 6 minutes.
The MB ACS Network is currently working with the Health Sciences Centre ER to match these improvements. We will expand TMT to other centres in Winnipeg and the larger ERs in the province, ensuring the best STEMI care for all Manitobans.
