Continuous quality improvement for prehospital STEMI improved triage rates and achievement of gold standard<90‐min EMS‐to‐balloon time
Dublin Core
Title
Continuous quality improvement for prehospital STEMI improved triage rates and achievement of gold standard<90‐min EMS‐to‐balloon time
Subject
ST-segment elevation MI (STEMI), Polk County Fire Rescue (PCFR), American Heart Association Mission
Lifeline STEMI
Lifeline STEMI
Description
Abstract
Background ST-elevation myocardial infarction (STEMI) is a type of myocardial infarction caused by a buildup
of plaque or clot in the coronary arteries. There are approximately 750,000 STEMI cases each year in the United States.
The American Heart Association’s Mission Lifeline initiative aimed to optimize prehospital emergency medical services
(EMS) and enhance STEMI triage rates through improved standardized protocol. This study evaluates the implementa-
tion of Mission Lifeline techniques by Polk County Fire Rescue (PCFR) on improved EMS-to-balloon (E2B) times and tri-
age rates.
Methods Data from PCFR, Florida’s 4th largest EMS system, were analyzed quarterly from 2015 to 2023. The study
included patients with chest pain that were>35 years of age.
Results Among 2,585 patients, the percentage meeting the 90-min EMS-to-Balloon time increased from 74% in 2015
to 84% by the year 2019. The average annual under-triage rate for STEMI decreased from ranging from 2% in 2015
to 4% in 2017 to below 1% after the year 2020, reaching as low as 0% in 2021 and 2023. Over-triage rates initially fluc-
tuated, increasing to a height of 12% by 2017, but decreased to<3% by 2022 and further dropped to 0.6% of cases
were over-triage by 2024.
Conclusion Implementation of Mission Lifeline procedures, including obtaining pre-hospital 12-lead ECG and hos-
pital pre-activation, significantly enhanced STEMI care. These interventions led to improved E2B times and more
accurate prehospital STEMI identification, underscoring the importance of coordinated, protocol-driven prehospital
STEMI care in improving patient outcomes.
Keywords ST-segment elevation MI (STEMI), Polk County Fire Rescue (PCFR), American Heart Association Mission
Lifeline STEMI
Background ST-elevation myocardial infarction (STEMI) is a type of myocardial infarction caused by a buildup
of plaque or clot in the coronary arteries. There are approximately 750,000 STEMI cases each year in the United States.
The American Heart Association’s Mission Lifeline initiative aimed to optimize prehospital emergency medical services
(EMS) and enhance STEMI triage rates through improved standardized protocol. This study evaluates the implementa-
tion of Mission Lifeline techniques by Polk County Fire Rescue (PCFR) on improved EMS-to-balloon (E2B) times and tri-
age rates.
Methods Data from PCFR, Florida’s 4th largest EMS system, were analyzed quarterly from 2015 to 2023. The study
included patients with chest pain that were>35 years of age.
Results Among 2,585 patients, the percentage meeting the 90-min EMS-to-Balloon time increased from 74% in 2015
to 84% by the year 2019. The average annual under-triage rate for STEMI decreased from ranging from 2% in 2015
to 4% in 2017 to below 1% after the year 2020, reaching as low as 0% in 2021 and 2023. Over-triage rates initially fluc-
tuated, increasing to a height of 12% by 2017, but decreased to<3% by 2022 and further dropped to 0.6% of cases
were over-triage by 2024.
Conclusion Implementation of Mission Lifeline procedures, including obtaining pre-hospital 12-lead ECG and hos-
pital pre-activation, significantly enhanced STEMI care. These interventions led to improved E2B times and more
accurate prehospital STEMI identification, underscoring the importance of coordinated, protocol-driven prehospital
STEMI care in improving patient outcomes.
Keywords ST-segment elevation MI (STEMI), Polk County Fire Rescue (PCFR), American Heart Association Mission
Lifeline STEMI
Creator
Aarish Reddy1
, Latha Ganti2,3,4, Anjali Banerjee5 and Paul Banerjee2,3*
, Latha Ganti2,3,4, Anjali Banerjee5 and Paul Banerjee2,3*
Source
https://doi.org/10.1186/s12245-025-00863-x
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Aarish Reddy1
, Latha Ganti2,3,4, Anjali Banerjee5 and Paul Banerjee2,3*, “Continuous quality improvement for prehospital STEMI improved triage rates and achievement of gold standard<90‐min EMS‐to‐balloon time,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12733.