STEMI Flashcards
(16 cards)
Recite the STEMI CPG
When is STEMI considered identified?
When STEMI is confirmed on ECG or monitor detects acute infarct.
What should be done immediately after STEMI is identified?
• Transmit ECG
• Request MICA (ALS)
• Treat per CPG A0401 Acute Coronary Syndromes
• Apply defib pads.
What is the protocol for STEMI with symptoms >12 hrs?
Continue management per CPG A0401 and transport with notification.
What four assessment factors determine PCI vs thrombolysis pathway?
• Time to PCI
• Inclusion criteria
• Exclusion criteria
• Relative contraindications.
When is urgent PCI transport indicated?
• PCI available < 1 hr OR
• PHT inclusion not met OR
• PHT exclusion criteria met.
What should be done if there’s any uncertainty around diagnosis or thrombolysis?
Consult with AV Clinician.
Who must consult before giving Heparin?
ALS paramedics must consult AV Clinician.
Should transport be delayed to consult or administer Heparin?
No, do not delay transport.
What treatment actions are taken during transport to PCI facility?
• Treat as per CPG A0401
• Notify hospital
• Administer Heparin IV bolus 4000 IU, repeat 1000 IU at 1 hr intervals
• Repeat ECG 30 min before arrival.
When is prehospital thrombolysis indicated?
• PCI > 1 hr
• All inclusion criteria met
• No exclusion criteria met.
Must ALS paramedics consult before thrombolysis?
Yes, they must consult AV Clinician in all cases.
What should MICA paramedics do if there are relative contraindications?
Consult AV Clinician.
What are the key actions for prehospital thrombolysis?
• IV access x2
• Normal Saline TKVO
• Explain/consent with checklist
• Administer Tenecteplase IV
• Administer Heparin 4000 IU IV, repeat 1000 IU hourly.
What ECG actions are required after thrombolysis?
• Transmit 12-lead ECG to hospital
• Repeat ECG 30 mins before arrival.
What is the definition and pathophysiology for STEMI
A STEMI is a type of heart attack caused by a complete blockage of a coronary artery, leading to full-thickness (transmural) damage of the heart muscle. It is diagnosed by persistent ST-segment elevation on ECG and elevated cardiac biomarkers (e.g. troponin).
