Stent & Surgery vs STEMIcathAID

The management of antiplatelet therapy in patients with coronary stents undergoing surgery is a growing clinical problem and often represents a matter of debate between cardiologists and surgeons. It has been estimated that about 4-8% of patients undergoing coronary stenting need to undergo surgery within the next year. The present consensus document provides practical recommendations on the management of antiplatelet therapy in the perioperative period in patients with coronary stents undergoing surgery. Cardiologists and surgeons contributed equally to its creation. An ischemic risk stratification has been provided on the basis of clinical and procedural data. All surgical interventions have been defined on the basis of the hemorrhagic risk. A consensus on the most appropriate antiplatelet regimen in the perioperative phase has been reached on the basis of the ischemic and hemorrhagic risk. This application allows to easily browse the document, by setting the parameters of the search and to display the results or send them by email.

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.