Understand the steps to take if you have a patient suffering ST-elevation myocardial infarction (STEMI), and access the latest clinical guidelines.

If you have a patient with STEMI, please arrange an ambulance as soon as possible by calling 0800 262 655. 

A clinician will answer your call, to ensure the most appropriate response for the patient. 

Primary care and managing STEMI 

Primary care clinicians aren’t expected to be proficient in the STEMI pathway but can assist paramedics with treatment.

When you have a patient with STEMI, please arrange an ambulance as soon as possible by calling 0800 262 655.

How to help a patient with STEMI

  • If possible, please get a 12-lead ECG before requesting an ambulance. 

  • Please let us know when you request an ambulance that you suspect a patient has STEMI, as this will determine which ambulance is sent. 

  • If you’re a primary care clinician who is trained to administer fibrinolytic therapy for STEMI, please do. 

  • Patients with STEMI do not always need to go to hospital, so there’s no need to phone the hospital to arrange admission for your patient before the ambulance arrives. 

How ambulance staff treat STEMI

  • Road and air ambulances staffed are equipped with a fibrinolytic kit containing clopidogrel, tenecteplase, heparin, enoxaparin and metoprolol to help treat STEMI. 

  • As part of the STEMI Pathway, paramedics will administer fibrinolytic therapy ASAP if the patient can’t reach a Percutaneous Coronary Intervention (PCI) capable hospital within 90 minutes. 

  • Depending on the preferences of the treating primary care clinician and the clinical circumstances, fibrinolysis can be administered in either the primary care facility or in the ambulance. 

  • Following this, ambulance personnel will transport the patient to a PCI- capable hospital.

 Read the STEMI clinical guidelines


Improvements to the Out-of-Hospital STEMI pathway

We track outcomes based on clinical guidelines and pathways so that we can constantly improve patient care. That’s why since 2016, ambulance staff have been able to administer fibrinolytic therapy during STEMI, if a patient can’t reach a PCI-capable hospital within 90 minutes of the diagnosis. 

This pathway was developed with the Regional Cardiac Networks and DHBs, and was signed off by the National Cardiac Network. 

Questions about STEMI

If you have any questions about STEMI and the clinical pathway, please email us.

 Read our annual STEMI reportS

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