MI Treatment Flashcards
1
Q
If any of the following are present then transfer to the nearest hospital with cardiac facilities needs to take place with a pre alert.
(JRCALC)
A
- any major ABC problems;
- the ECG shows STEMI or LBBB with features of ACS (Central CP, crushing or constricting in nature, >15 mins, may present in upper abdo, shoulder, arm, jaw, neck)
- or there is a suspected ACS with haemodynamic instability
2
Q
En route (JRCALC)
A
Management of patient to continue en-route. Incl.
1. Sending a 12L ECG to the PPCI to be assessed for suitability for reperfusion treatment.
- Administering of drugs
- O2 if
3
Q
On the way the following drugs should be administered:
A
- Aspirin (300mg) - Anti-platelet, analgesic, Anti-pyretic, Anti-inflammatory
- Clopidogrel (600mg if PPCI, 300mg if thrombolytic) - Inhibits platelet aggregation
- Glyceryl tri-nitrate (GTN) (400-800mcg aka 1-2 sprays) - repeat 5-10 mins if discomfort persists – Potent vasodilator
4
Q
Local guidelines for ACS/MI treatment
A
- Send telemetry prior to leaving (this would help establish destination)
- Gain IV access and that this should preferably be in the left arm or hand.
- The crew does not have to wait for the PPCI site to accept patient.
- Only 400mcg GTN (1 spray) initial dosage
- Pain relief recommendations are for Entonox and Morphine.
- On arrival at hospital the crew should take O2, BVM, and Defibrillator and continue to monitor 12 lead.
- Ensure professional handover.
Documentation!
5
Q
Otyher considerations of MI
A
- Diabetics may not have the chest pain due to neuropathic damage cause by the high sugar levels.
- Ethnic minorities may experience abdominal discomfort.
- Elderly patients may present with altered mental state.
