STEMI Scribe Checklist / Apply Patient Sticker Here / Apply Patient Sticker Here
Date: / STEMI Scribe Name:
Patient Name: / Hospital: University of Virginia
Check boxes / Call Team Manager @ 111-1111. Notify them of STEMI ALERT Remember,
Important! Distribute STEMI checklists to nurse and physician TIME IS MUSCLE!
Notify registration of patient. If no name, use a STEMI Patient Number
Place order for cardiac care set in MIS, including portable CXR
Start to complete Data sheets A & B. Record times on both, please
If applicable, record time ED attending activates cath lab. Ask attending please.
If requested by the ED Attending, page the CCU fellow (pager #0000). Enter ED Attending’s direct Nextel phone number for the return number. Record time page goes out.
If CCU fellow does not respond to a STEMI activation alert or STAT page within five minutes, automatically re-page them at #0000. Notify ED attending of page failure. If no response in 10 minutes despite two pages, ED attending may request that you page the CCU attending. Call operator to get #.
If a pre-arrival ECG was done by EMS, staple a copy to the “ECG Collection Sheet.” This form is attached to data Sheet A
Complete section I of Data sheets A and B. If you don’t know times, check with the nurse and physician involved in case. Make sure to note if a pre-hospital ECG was done.
Make sure that Data Sheet B (yellow) and a copy of the ECG goes to cath lab with Pt. They must be placed with patient on gurney when they leave ED; not sent via the tube system,
IMPORTANT: note on Data sheet A the time the cath lab calls for patient.
After alert, collect ((3) color-coded checklists, Data sheet A and ECG collection sheet. Place into the red inter-departmental envelope. Put in Barbara Anderson’s mailbox.
Write comments below (reviewed by Dr. Burt)
ED shift manager: 444-4444
Cath lab 1-2345
CCU fellow PIC # 0000 CCU 2-2222 / Comments –what went right or wrong?
www.projectupstart.com NOT PART OF THE MEDICAL RECORD 12.25.08