Study finds that 22% of STEMI patients untreated
Of 460 patients with acute myocardial infarction (MI) coming to five EDs in Colorado and California between 2000 and 2002, 22% did not receive reperfusion therapy even though they were eligible, according to a new study.1
"The biggest implication for ED nurses is simply to be aware that we are undertreating one in five patients with ST-elevation MI," says Albert J. Tricomi, MD, the study's lead author and a senior instructor at University of Rochester.
There are several reason for this, including failure to recognize important electrocardiogram (EKG) abnormalities, he says. "Nurses should be aware that certain groups of patients, including the elderly, those with peripheral vascular disease, and those presenting with atypical symptoms are more likely to not receive therapy," he adds.
ED nurses should be sure to promptly alert physicians when patients present with typical or atypical cardiac symptoms, and for any abnormal EKG interpretations, urges Tricomi. "This is particularly important when subsequent EKGs are performed after the initial evaluation," he says.
Reference
- Tricomi AJ, Magid DJ, Rumsfeld JS, et al. Missed opportunities for reperfusion therapy for ST-segment elevation myocardial infarction: Results of the Emergency Department Quality in Myocardial Infarction (EDQMI) study. Am Heart J 2008; 155:471-477.
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