ACS management in prehospital and ED

Patient’s Throughput:In patients with ACS, throughput is divided to two parts: 1. Prehospital phase, and 2. Emergency ward phase.In prehospital phase, throughput includes:1. Patients or their families call to 115 and 115 operator asks him/her some questions about their history and patient’s location.2. This Mission is announced to dispatch. Dispatch has been notified the mission to the nearest pre-hospital emergency unit.3. Ambulance was arrived to the scene and prehospital interventions were done and patient was transported to the hospital with appropriate facilities.4. In any parts, if needed, consultation with physician was done.Emergency ward phase:1. The patient was triaged.2. ED’s physician assessment.3. Nurse executed medical orders.4. Make decision, and if needed: Cath lab was activated.Telemedicine device and 247 code Telemedicine is a bridge between prehospital and hospital phase. Telemedicine send the patients information such as demographic and ECG to specialist dispatch. 247 code was started from 2016 for ACS patients in IRAN. 247 means: 24 hours of a day and 7 days of a week, when a patient with suspected ACS calls to EMS, this code was activated and at the scene the patient’s ECG was sent to appropriate hospital via telemedicine device. If specialist dispatch diagnosed AMI with ECG, the Cath lab was activated in the period of time till patient was delivered to hospital and the patient was transported to Cath lab directly to reduce door to needle time .Our goal: Reduce short-term and long-term complications of AMI. Best regards