ACLS Acute Coronary Syndrome

Acute Coronary Syndrome

Women Unusual Fatigue

Sweating is a great objective sign


  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


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



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



PO b blockers slows and decrease contractility

Cardiac enzymes


In the meantime




Pulmonary Edema