ACS

Question 1

What should EMS complete prior to coming to ED w/ a patient with ACS S/S?

Answer 1

1. Assess ABCs (be prepared for CPR/defibrillation)
2. Administer aspirin and consider 02, nitro, and morphine
3. obtain 12 lead ECG
4. if ST elevation is present, they should notify hospital

Question 2

If pt is stable and arrives to the ED, what should the nurse do?

Answer 2

1. activate STEMI
2. assess ABCs and give 02 if necessary + EKG
3. establish IV access
4. perform brief history/physical exam
5. obtain cardiac marker levels, CBC, and coagulation studies
6. obtain portabel CXR < 30 minutes

Question 3

If pt is unstable, what should the nurse do on arrival to ED?

Answer 3

1. Administer 02 if necessary
2. Aspirin 162-325 mg (if not given by EMS)
3. Nitro SL
4. Morphine if discomfort not relieved by nitro
5. PsY12 inhibitors

Question 4

Pt’s EKG reads STEMI and S/S have been present for less then 12 hours, what would you do?

Answer 4

-PCI within 90 minutes of arrival
-fibrinolysis within 30 minutes of arrival

Question 5

S/S of a STEMI

Answer 5

S/S: Chest pain: pressure, fullness, squeezing, or pain in chest lasting several minutes, chest discomfort that radiates to shoulder/neck/arms/jaw/back/between scapulas, N/V, dizzy, lightheaded, fainting, syncope, diaphoresis, SOB, and epigastric pain/indigestion

Question 6

What qualifies as a STEMI when evaluating an EKG?

Answer 6

ST elevation in 2 or more contiguous leads or new LBBB