EMS Barriers & Solutions

Updated:Jul 19,2011

EMS systems face a variety of barriers to achieving the ideal STEMI care practice.
However, there are solutions, as depicted in the chart below.

BARRIERSSOLUTIONS
Lack resources:
  • Electrocardiogram (ECG) equipment
  • Appropriate level of EMS provider
  • Medical leadership
  • Funding, particularly in rural or impoverished areas
"Creative funding"
  • Multiple source grant writing
  • County board of education
Lack training to obtain 12-lead ECG and recognize STEMI
  • STEMI training courses
  • Case review
  • Advocacy-change laws
Lack of destination protocols
  • Stakeholder STEMI steering agreement
  • Buy-in from all entities
  • Plan to implement
  • Advocacy
No protocol for:
  • Pre-hospital diagnosis
  • Advance notification
  • Cath. Lab activation
  • False activation
  • Meet with EMS director, hospital and/or medical leadership to establish protocol
  • Monitor "appropriate activation"
Transfer patients are second to 9-1-1 calls
  • Change policy for transfer patients with STEMI to be viewed as 9-1-1
  • Local, city, county and state advocacy
Lack training on STEMI guidelines
  • STEMI training course
  • New STEMI chapter
No existing link between EMS and PCI-capable hospital for data feedbackEstablish data feedback for entire STEMI team