Photo Credit: gorodenkoff

The following is a summary of “Continuous quality improvement for prehospital STEMI improved triage rates and achievement of gold standard < 90-min EMS-to-balloon time,” published in the March 2025 issue of International Journal of Emergency Medicine by Reddy et al. 

ST-elevation myocardial infarction (STEMI), a heart attack caused by coronary artery blockage, affects roughly 7,50,000 people annually in the United States.  

Researchers conducted a retrospective study to assess the impact of Polk County Fire Rescue’s implementation of Mission Lifeline techniques on emergency medical services (EMS)-to-balloon times and STEMI triage rates.  

They analyzed quarterly data from Polk County Fire Rescue (PCFR), the fourth-largest EMS system in Florida, covering the period from 2015 to 2023. The study included individuals over 35 years old who experienced chest pain.  

The results showed that among 2,585 individuals, the percentage achieving the 90-minute EMS-to-balloon time increased from 74% in 2015 to 84% by 2019. The annual under-triage rate for STEMI declined from 2% in 2015 to 4% in 2017, dropping below 1% after 2020 and reaching 0% in both 2021 and 2023. Over-triage rates initially fluctuated, peaking at 12% in 2017, but declined to less than 3% by 2022 and further decreased to 0.6% by 2024.  

Investigators concluded that Mission Lifeline procedures, including pre-hospital ECG and hospital pre-activation, improved STEMI care by reducing Door-to-balloon (E2B) times and enhancing prehospital identification. 

Source: intjem.biomedcentral.com/articles/10.1186/s12245-025-00863-x