ACLS Acute Coronary Syndrome

Acute Coronary Syndrome

Women Unusual Fatigue

Sweating is a great objective sign

ABC

  1. Consciousness/Discomfort
  2. Breathing
  3. Pulse
  4. 02 Sat SP02 94-95%
  5. BP  – >90
  6. IV
  7. Monitor/AED/12 lead EKG

 

If ST Elevation – IF ST Elevation Activate alert STEMI team

Aspirin 16-325mg

TNG sublingual spray Ask about Viagra or Cialis

IV morphine 2–4 mg IV  at 5–15‐minute intervals with increments of 2–8 mg IV

 

In Hospital Assessment

If STEMI

1st 10 mins Re Assess pt

  1. oxygen (4L/min spO2 = 94%)
  2. breathing airway
  3. pulse pressure
  4. IV
  5. EKG (ST elevation 9(“tombstone”J point is greater than 2 mm in leads V2 and V3  )or new LBBB

Image result for ECG ST segment elevation wiki

fib-img1

 

Left bundle branch block ECG characteristics.png

1st 30 minutes CXR

 

Fibrinolytics within 30 minutes OR

Cath lab PCI within 90minutes from arrival to ED or 120 minutes from 1st medical contact

STEMI Check List

If ST depression or T wave inversion = ischemia

 

TNG sublingual

Aspirin

Heparin

PO b blockers slows and decrease contractility

Cardiac enzymes

 

In the meantime

Rx

Pain

Hypotension

Pulmonary Edema