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    STEMI Clinical Pathway

    Uploaded by

    Kanoknun Pisitpatcaragul
    This document appears to be a clinical pathway for treating patients experiencing ST elevation myocardial infarction (STEMI). It outlines screening for signs and symptoms of STEMI, contraindications for certain medications, transferring the patient to the emergency room, conducting assessments like EKG and lab tests, consulting cardiology, and determining whether the patient should receive primary percutaneous coronary intervention (PCI), fibrinolysis, or other treatments like coronary artery bypass grafting (CABG) or medical therapy depending on factors like time since chest pain onset. The goal is to reperfuse the heart as quickly as possible in STEMI patients.

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    STEMI Clinical Pathway

    Uploaded by

    Kanoknun Pisitpatcaragul
    116 views1 page
    This document appears to be a clinical pathway for treating patients experiencing ST elevation myocardial infarction (STEMI). It outlines screening for signs and symptoms of STEMI, contraindications for certain medications, transferring the patient to the emergency room, conducting assessments like EKG and lab tests, consulting cardiology, and determining whether the patient should receive primary percutaneous coronary intervention (PCI), fibrinolysis, or other treatments like coronary artery bypass grafting (CABG) or medical therapy depending on factors like time since chest pain onset. The goal is to reperfuse the heart as quickly as possible in STEMI patients.

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    This document appears to be a clinical pathway for treating patients experiencing ST elevation myocardial infarction (STEMI). It outlines screening for signs and symptoms of STEMI, contraindications for certain medications, transferring the patient to the emergency room, conducting assessments like EKG and lab tests, consulting cardiology, and determining whether the patient should receive primary percutaneous coronary intervention (PCI), fibrinolysis, or other treatments like coronary artery bypass grafting (CABG) or medical therapy depending on factors like time since chest pain onset. The goal is to reperfuse the heart as quickly as possible in STEMI patients.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    116 views1 page

    STEMI Clinical Pathway

    Uploaded by

    Kanoknun Pisitpatcaragul
    This document appears to be a clinical pathway for treating patients experiencing ST elevation myocardial infarction (STEMI). It outlines screening for signs and symptoms of STEMI, contraindications for certain medications, transferring the patient to the emergency room, conducting assessments like EKG and lab tests, consulting cardiology, and determining whether the patient should receive primary percutaneous coronary intervention (PCI), fibrinolysis, or other treatments like coronary artery bypass grafting (CABG) or medical therapy depending on factors like time since chest pain onset. The goal is to reperfuse the heart as quickly as possible in STEMI patients.

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    Name…………...…...

    Surname…………………
    STEMI Clinical Pathway Date of Birth………………………………………
    HN……………………...AN……………………..

    Screening Nurse / Registration officer found signs and symptoms of STEMI :


    Chest pain  Discomfort at chest area  Sprain at shoulder Sprain at jaw Epigastrium pain
    Tired easily  Weakness  Fatiqued Acute Hypotension Cardiac arrest
    Date ……………………………....time of Symptom……………………………....arrival time………………………………..

    ***Check Contraindication for anti-platelet ,


    anticoagulant and fibrinolysis Transfer patient to ER
    1. History of hemorrhagic stroke
    2. History of nonhemorrhagic stroke in 1 year
    3. Intra Abdominal Hemorrhage
    V/S ……………………..  O2sat……………... pain score…………….
    4.Recent major trauma / surgery in 4 weeks
    EKG12 Lead ( Start time to EKG …………….……... )
    5. Aortic dissection
    Risk stratification: GRACE risk score………………..
    6. Refractory Hypertension ( SBP> 180 mmHg )
    Lab: CBC, BUN, Cr, Electrolyte
    7.Thrombocytopenia / current use of
    Troponin T
    anticoagulants : the higher INR ( warfarinINR
    Anti-HIV
    > 2)
    CXR
    8. Resuscitation than 10 minutes
    On oxygen Keep sat.95 %
    Check contraindication for anti-platelet , anticoagulant and fibrinolysis***
    9. Pregnancy
    R/O STEMI : Consult Cardio (Start time to consult ………………….)
     ASA…………………….................. ( Start time …………….....)
     Plavix…………………....................( Start time ………………..)
     UHF………………………......……..( Start time………………...)

    EKG Show

    STEMI
    -ST elevation NSTEMI
    -New LBBB

    Primary PCI Fibrinolysis

    Start Anti-platele Check contraindication for Fibrinolysis


    ASA gr V 1 tab oral Start…………….. Chest pain ≤ 12 hours
     Plavix 600 mg oral Start…………….. Fibrinolysis Drug………………………….
     UFH Abciximab  Eptifibatide Admit CCU
    ………………………………………..
     Inform Consent for PCI
     Admit CCU Failed reperfusion

    Primary CABG Medical


    PCI Therapy Reference : WP-PCT-002-00

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