Completing the feedback loop to EMS and referring hospitals
Completing the feedback loop to EMS and referring hospitals
Completing the feedback loop to EMS and referring hospitals
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STEMI Feedback<br />
Admission Date:<br />
Acct Number<br />
Transfer Stemi Tracking Sheet<br />
Goals<br />
Arrival time <strong>to</strong><br />
<strong>referring</strong> hospital<br />
Chest pain onset<br />
Did PT receive TNK<br />
Mode of arrival<br />
Transferring Hospital Time<br />
Arrival time <strong>to</strong> EKG<br />
(<strong>referring</strong> hospital)<br />
EKG <strong>to</strong> call <strong>to</strong><br />
transport service<br />
Arrival time <strong>to</strong> TNK<br />
Time of contact with<br />
Cardiologist<br />
Departure time from<br />
<strong>referring</strong> hospital<br />
Arrival time<br />
EKG Time<br />
Arrival time<br />
Card Time<br />
Arrival time<br />
EKG Time<br />
Alert Time<br />
TNK Time<br />
Dep Time<br />
Dep Time<br />
Time in Min<br />
Time in Min<br />
Time in Min<br />
Time in Min<br />
0:00<br />
Time in Min<br />
Notes<br />
Transferring Hospital<br />
Time<br />
0:00<br />
Departure time <strong>to</strong><br />
Arrival time at RCRH<br />
Dep Time<br />
Arrival Time<br />
Time in Min<br />
Notes<br />
Transport Time 0:00<br />
Arrival time <strong>to</strong> Cath<br />
lab departure time<br />
Arrival Time<br />
Dep Time<br />
Time in Min<br />
Notes<br />
PCI TIME<br />
Dep from ED <strong>to</strong> arrival<br />
<strong>to</strong> cath lab<br />
Arrival <strong>to</strong> cath lab <strong>to</strong><br />
case start<br />
Dep Time<br />
Arrival Time<br />
Arrival time Case Start<br />
Time in Min<br />
Time in Min<br />
Case start <strong>to</strong><br />
Reperfusion<br />
Case Start Reperfusion<br />
Time in Min<br />
90 Min<br />
Door 2 Balloon Time 0:00<br />
Total PCI Time 0:00<br />
Referring Hospital<br />
physician<br />
Noninterventionalist<br />
Interventionalist<br />
STAFF<br />
ED Staff<br />
Cath Lab Staff<br />
Reasons for Delay<br />
Patient Expired<br />
Notes:
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