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< 10 minutes of arriving at the ED
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< 30 minutes of arriving at the ED
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ACLS ACS algorithm

QuestionAnswer
< 10 minutes of arriving at the ED 1.STEMI team, 2) ABCs, O2 prn, MONA, consider P2Y12 inhiibator, 3)IV, 4)H&P, 5)fibrinolytic checklist, 6)labs:enzymes, CBC, coag, 7)EKG
< 30 minutes of arriving at the ED portable chest XRay
STEMI or new BBB < 12 hours of onset of symptoms and < 90 min of FMC Do PCI, a balloon catheter is inserted past the blockage and then inflated past the blockage
define first medical contact when EMS sees patient
define "to balloon" coronary artery reperfusion via percutaneous coronary intervention
S/s of cardiogenic shock 1)hypotension; 2)diaphoresis; 3)tachycardia; 4)cool extremities; 5)pale skin
STEMI or new BBB if time of onset < 12 hours and > 90 min of FMC Fibrinolytics, (TPA) if no contraindications
STEMI or new BBB >12 hours of onset of symptoms 1)assess for ongoing ischemia (refractory CP, hemodynamic instability, dynamic EKG changes, ventricular arrhythmias), if present can still pursue PCI, If not present, medical management
treatment for NSTEMI 1)troponin level; 2)Cardiology consult; 3)DAPT & Anticoagulant; If ongoing ischemia
NSTEMI with continuing injury 1)urgent coronary angiography; 2)PCI or CABG
indication for CABG multi-vessel involvement or left main coronary artery disease
anticoagulants 1)examples: coumadin, apixaban; 2)blood thinners; 3)
antiplatelets 1)example: aspirin; 2)Keep blood products from sticking together,
DAPT, Dual antiplatelet therapy aspirin and a P2Y12 inhibitor
example of p2y12 1)ex, clopidogrel, ticagrelor
what is never indicated for NSTEMI or unstable angina fibrinolysis
antiplatelets P2y12 inhibitors
what to do within the first 90 minutes of arrival at the ED PCI
what to do within the first 30 minutes of arrival at the ED fibrinolytics , (CXR)b
which is better, PCI or fibrinolytics PCI
ex of fibrinolytic alteplase
Biggest drop is SBP allowed is 10% of baseline in normotensive patients and 30mm hg below baseline in hypertensive patients
Created by: Iloveheidicocoa
 

 



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