ST-Elevation Myocardial Infarction (STEMI) is a clinical syndrome defined by characteristic symptoms of myocardial infarction or acute myocardial infarction, commonly known as a heart attack. A heart attack occurs when blood stops flowing properly to part of the heart, injuring the heart muscle due to lack of oxygen. The most common way to determine if a person has had a myocardial infarction is through electrocardiograms (ECGs) that trace the electrical signals in the heart. ECG testing is used to differentiate between two types of myocardial infarctions based on the shape of the tracing. An ST section of the tracing that is higher than the baseline is considered to be a STEMI. A STEMI usually requires aggressive treatment in a timely manner to prevent permanent heart damage.

STEMI is treated by restoring circulation to the heart, called reperfusion therapy, and typical methods are angioplasty, where the arteries are pushed open, and thrombolysis, where the blockage is removed using medications.

The Early Management of Adults with STEMI

The EMS Authority staff participated in a STEMI Work Group co-convened by the American Heart Association and the California Department of Public Health, STEMI & Stroke Prevention Program. The work group developed the STEMI guidelines titled “Recommendations for the Early Management of Adults with ST–Elevation Myocardial Infarction (STEMI)”.

Local STEMI Systems

Some local EMS agencies have developed STEMI Systems. The systems vary among local EMS agencies. The American Heart Association/American Stroke Association is conducting a detailed survey on STEMI system approaches.  The EMS Authority has identified the following local EMS agencies as developing/implementing a STEMI System of Care Program: Alameda, Coastal Valleys, Contra Costa, El Dorado, Inland Counties, Kern, Los Angeles, Marin, Merced, Monterey, Mountain Valley, Napa, Orange, Riverside, Sacramento, San Diego, San Francisco, San Joaquin, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Sierra-Sacramento Valley, Solano, Tuolumne and Ventura EMS.

Save The Date - June 27, 2022 - California State STEMI Summit 2022
California State STEMI Summit 2021

California State STEMI Summit 2021

On June 9, 2021, the California Emergency Medical Services Authority (EMSA) held the first-ever California State STEMI Summit. The first run of this annual event focused on key topics of STEMI Systems of Care, Updates in STEMI Management, and the Future of STEMI Care, among other topics.

If you missed the Summit, or would like to revisit some of the talks given during the half-day event, you can view a video recording of the entire 2021 California State STEMI Summit here:

*Please note, CE/CME credits are not available to viewers who did not register for and attend the entire event on June 9, 2021.

STEMI Regulations

California statute mandates the EMS Authority to adopt necessary regulations to carry out the coordination and integration of all state activities concerning EMS (Health and Safety Code § 1797.107).

In addition, the statute allows the EMS Authority to establish guidelines for hospital facilities, in cooperation with affected medical organizations, according to critical care capabilities (Health and Safety Code § 1798.150).

As a result of these statutes, the EMS Authority established a multidisciplinary taskforce for the development of STEMI System of Care Regulations for California.

The proposed rulemaking action adopting STEMI regulations (Chapter 7.1 of Division 9, Title 22, of the California Code of Regulations) was approved by the Office of Administrative Law on Friday, April 19, 2019, and took effect on July 1, 2019.

STEMI Critical Care System Regulations