ACLS ACS algorithm
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| < 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
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| < 30 minutes of arriving at the ED | portable chest XRay
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| 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
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| define first medical contact | when EMS sees patient
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| define "to balloon" | coronary artery reperfusion via percutaneous coronary intervention
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| S/s of cardiogenic shock | 1)hypotension; 2)diaphoresis; 3)tachycardia; 4)cool extremities; 5)pale skin
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| STEMI or new BBB if time of onset < 12 hours and > 90 min of FMC | Fibrinolytics, (TPA) if no contraindications
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| 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
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| treatment for NSTEMI | 1)troponin level; 2)Cardiology consult; 3)DAPT & Anticoagulant; If ongoing ischemia
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| NSTEMI with continuing injury | 1)urgent coronary angiography; 2)PCI or CABG
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| indication for CABG | multi-vessel involvement or left main coronary artery disease
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| anticoagulants | 1)examples: coumadin, apixaban; 2)blood thinners; 3)
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| antiplatelets | 1)example: aspirin; 2)Keep blood products from sticking together,
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| DAPT, Dual antiplatelet therapy | aspirin and a P2Y12 inhibitor
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| example of p2y12 | 1)ex, clopidogrel, ticagrelor
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| what is never indicated for NSTEMI or unstable angina | fibrinolysis
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| antiplatelets | P2y12 inhibitors
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| what to do within the first 90 minutes of arrival at the ED | PCI
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| what to do within the first 30 minutes of arrival at the ED | fibrinolytics , (CXR)b
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| which is better, PCI or fibrinolytics | PCI
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| ex of fibrinolytic | alteplase
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| Biggest drop is SBP allowed is | 10% of baseline in normotensive patients and 30mm hg below baseline in hypertensive patients
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