Abstract 18299: Development of a Regional STEMI Management Guideline Significantly Increases Fibrinolytic Therapy Prior to Emergent Transfer for Percutaneous Intervention

Introduction: PCI is established as definitive care for STEMI. This therapy is rarely available in rural hospitals. The Southwest Texas Regional Advisory Council developed a STEMI Management Guideline that included two goals: 1. EMS shall bypass urban non-PCI capable hospitals to primary PCI capable hospitals for all STEMI, and rural EMS systems should transport to the closest referral facility. Goal 2. STEMI referral facilities should initiate thrombolysis with emergent transfer for PCI. The goal of this study was to evaluate the impact of the deployment of a region wide consensus clinical practice guideline. Methods: The guideline was fully implemented in June 2015. All ACTION Registry qualifying STEMI patients from October 2012 through December of 2016 were included. The pre-guideline group was defined as all STEMI’s before June 2015. The AHA Mission Lifeline Quarterly reports were used to trend the percent of transfer patients that were reperfused by thrombolytics. Descriptive statistics were used to ...