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Conditions/Treatment

Cardiology - paramedicine

QuestionAnswer
ACS Aspirin 300mg GTN 300-600mcg + 50mg patch Ondansetron 4mg ~ morphine/fentanyl
Aspirin minimises platelet aggregation - active bleeding peptic ulcers - bleeding disorders - chest pain associated with psychostimulant overdose - dissecting aortic aneurism - hypersensitivity
Glyceryl trinitrate increase perfusion; reduces intracellular calcium in smooth muscle cells; causes dilation of blood vessels - hypersensitivity, >50BPM, >160bpm, BP <90 for patch, BP <110 for tablet, cialis/lavitra/viagra, VT, right MI, inferior STEMI
Ondansetron reduces nausea and vomiting - known long QT syndrome - hypersensitivity - concurrent apomorphine use - hypokalaemia or hypomagnesia
STEMI transmit 12 lead, request MICA, treat as ACS, transport <1hr heparin 4000IU, >1hr heparin 4000IU and tenecteplase 1000IU
heparin anticoagulant - hypersensitive, active bleeding, oral anticoagulant, bleeding disorders, HIT, hepatic impairment, recent trauma or surgery
teneceteplase fibrinolytic - major surgery, significant head injury, major trauma, stroke, ICH, GI bleed, bleeding disorders, anticoagulants, allergy
STEMI diagnosis >2.5mm ST elevation in leads v2-3 in men aged <40yrs >2mm ST elevation in leads v2-3 in men aged >40yrs >1.5mm ST elevation in leads v2-3 in women >1mm in other leads new onset left bundle-branch block
APO GTN 300-600mcg + 50mg patch CPAP 10L morphine 2.5-5mg IV
CPAP constant level of positive pressure applied to a spontaneous breathing cycle - GCS <13, facial trauma, pneumothorax, active vomiting, life threatening arrhythmias, secure airway, hypoventilation
SVT valsalva manœuvre - 40mmhg pressure for 15sec in semi-recumbent position followed by 15 seconds supine passive leg raise at 45 degree angle 2 minute gap between
Bradycardia MICA - atropine, adrenaline, midazolam
Tachycardia (narrow complex) record 12 lead SBP >90mmhg modified or standard valsalva x3
Prinzmetal’s angina GTN transport to hospital
pericarditis STEMI pathways, analgesia and transport
haemorrhagic hypovolaemia >70 SBP, treat without fluid, and consult if they deteriorate <70 SBP, treat with 250ml saline and consult
chest pain muscular, pulmonary embolism, ACS, anxiety, pericarditis
STEMI mimics transmit 12 lead, request MICA, treat as ACS, transport <1hr heparin 4000IU, >1hr heparin 4000IU and tenecteplase 1000IU
Created by: ZoDunk
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