STEMIcathAID vs HINTS Exam

STEMIcathAID is a patient recognition, response, and record-keeping system designed to improve outcomes through adherence the American Heart Association’s Mission:Lifeline STEMI guidelines. Early restoration of blood flow to occluded coronary vessels has been shown to significantly improve outcomes for high-risk STEMI patients. STEMIcathAID aims to improve these clinical outcomes by optimizing their treatment following many of the recommendations of the AHA by reducing the time to STEMI recognition, lead acquisition, STEMI identification, notification of the catheterization lab, and reperfusion. There are multiple personnel and steps involved in caring for these high-risk patients. STEMIcathAID takes an algorithmic approach which will enhance the coordination and communication tasks essential to rapid assessment and easy transfer of STEMI patients from the field or outside facility. It will also provide protocols for the EMS or outside hospital provider to identify patients in cardiogenic shock even before their arrival in the catheterization lab. The application will integrate live GPS tracking of the patients alongside the time the alarm was raised prompting the sense of urgency in transferring the patient. Incorporating images, videos, illustrations, and live GPS tracking of the EMS, the design will be subdivided into three main sections: 1. EKG Upload by outside facility or EMS 2. Assessment of Cardiogenic Shock 3. STEMI patient transfer pathway When a medical provider, in the field, other hospital, or outpatient office, suspects STEMI, the provider uploads the EKG by taking a picture of it with their phone. Once the EKG is uploaded, the on-call attending at the PCI-capable facility receives a notification from the application. If the attending believes the patient is experiencing a real STEMI, the pathway is activated. Upon activation, the approximately 10-12 people involved in taking care of the patient are notified so they can begin preparations. Adhering to HIPAA compliance, all users log into the encrypted application and begin to collaborate such aspects as patient vitals, shock information, and emergency vehicle current location and estimated arrival time to the cath lab. Through the optimized communication and collaboration of multiple key players in the STEMI pathway, these time-critical, vulnerable patients can begin treatment promptly.

This app was developed to enhance the HINTS exam by using a smartphone to better facilitate effective exam implementation and improve posterior CVA detection for enhanced patient outcomes within primary care, urgent care, and emergency care settings. This application allows for a streamlined screening process, with most full exams being concluded within five minutes from the start, and subjectively, being able to replay the exam video at half-speed allowed for a much easier and more confident assessment of nystagmus direction, skew deviation, and head impulse test corrective saccade with correct training and understanding of the exam's application. The smartphone application starts by taking the user through several screening questions to help determine if the application is appropriate or if a stroke workup is highly indicated. Videos are recorded for review and can be slowed down for optimal evaluation.