Code STEMI
Formal Definition
A hospital-level activation protocol triggered by ST-elevation myocardial infarction on EKG, mobilizing the catheterization laboratory team for emergent percutaneous coronary intervention (PCI); designed to minimize door-to-balloon time to ≤90 minutes from first medical contact.
How It's Used on the Ward
"Calling a code STEMI" or "we STEMIed the patient" — activates a parallel team response that bypasses normal admission workflow to rush the patient directly to the cath lab.
Example
""EKG shows 4mm ST elevation in leads II, III, aVF — inferior STEMI. Calling a code STEMI: cath lab activating, cards fellow at bedside in 4 minutes, patient to cath lab in 22 minutes from door. Door-to-balloon 58 minutes.""
Clinical Context
STEMI criteria: ≥1mm ST elevation in ≥2 contiguous limb leads, or ≥2mm in precordial leads; LBBB (new or presumed new) is treated as STEMI-equivalent. Posterior MI can appear as ST depression in V1–V3 — posterior leads needed. Time is muscle: for every 30 minutes of delay, mortality increases measurably. Know your institution's code STEMI algorithm before being on call.
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