STEMI management

Question 1

What are the treatment steps for STEMI management?

Answer 1

Transmit ECG
Request MICA
Treat as ACS

Thenn determine transport facility

Question 2

When is urgent transport to a PCI facility required?

Answer 2

When time to PCI is <1 hour

Question 3

WHat is the treatment if time to PCI is <1 hour

Answer 3

Continue Mx as ACS
Tran sport with hospital notification
Heparin IV Bolus 4000IU
- repeat 1000IU hourly
Capture ECG every 30 mins

Question 4

When is pre-hospital thrombolysis indicated?

Answer 4

When time to PCI is over 1 hour

Question 5

What is the treatment is pre-hospital thrombolysis is indicated?

Answer 5

• IV access X2 with NS TKVO
• Complete thrombolysis checklist
• Tenecteplase IV Bplus
• Heparin IV Bolus 4000 IU
• > repeat heparin 1000 IU every hour
• transport with notification
• transmit 12 lead ecg
• capture ecg every 30 mins

Question 6

What are the contras for heparin?

Answer 6

1. Known hypersensitivity
2. Active bleeding (excluding menses)
3. Oral anticoagulants
4. Bleeding disorders
5. History of heparin-induced thrombocytopenia
   - Severe hepatic impairment including oesophageal varices
   - Recent trauma or surgery

Question 7

What are the precautions for Heparin

Answer 7

renal impairment

Question 8

Whata re the side effects of heparin?

Answer 8

• Bleeding
• Bruising and pain at injection site
• Hyperkalaemia
• Thrombocytopaenia