< 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

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

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 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

1)troponin level; 2)Cardiology consult; 3)DAPT & Anticoagulant; If ongoing ischemia

NSTEMI with continuing injury

1)urgent coronary angiography; 2)PCI or CABG

multi-vessel involvement or left main coronary artery disease

1)examples: coumadin, apixaban; 2)blood thinners; 3)

1)example: aspirin; 2)Keep blood products from sticking together,

Biggest drop is SBP allowed is

10% of baseline in normotensive patients and 30mm hg below baseline in hypertensive patients

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ACLS ACS algorithm

Question	Answer
< 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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