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https://resources.acls.com/free-resources/acls-algorithms/acute-coronary-syndrome#:~:text=Once%20STEMI%20has%20been%20determined%2C%20start%20adjunctive%20treatments,treat%20as%20a%20troponin%20elevated%20or%20high-risk%20patient.
https://www.cardioguide.ca/stemi/
STEMI + Symptom duration < 12hrs + ineligible for thrombolysis (Class I) STEMI (irrespective of symptom duration) if one of: (Class I) Cardiogenic shock; Acute severe heart failure; STEMI + symptom duration >12 hrs + …
https://litfl.com/stemi-management/
All patients who present within 12 hours of symptom onset of STEMI should be considered for a reperfusion strategy, unless they have severe co-morbidities. Reperfusion is not routinely recommended in patients who present more than 12 hours after symptom onset. It may be considered however in selected cases when: There are ongoing symptoms
https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/coronary-artery-disease-stemi
Primary PCI is not recommended when symptom onset is more than 12 hours and the patient is asymptomatic; see Occluded Artery Trial, or OAT. Fibrinolytic Therapy Fibrinolytic therapy must be ...
https://www.healthy.arkansas.gov/images/uploads/pdf/AR_STEMI_Systems_of_Care_Manual_7.2018.pdf
Keep patient on ambulance stretcher for STEMI evaluation in hospitals that routinely transfer by the same ambulance. 12-LEAD ECG PCI-Receiving hospitals should collaborate with EMS to receive 12-lead ECG transmission 24 hours per day/ 7 days a week. EMS should transmit 12-lead ECGs if technically
https://www.saintalphonsus.org/assets/documents/stemithrombolyticorderset.pdf
STEMI PROTOCOL – THROMBOLYTIC ORDERS STEMI Criteria: *ST Elevation Myocardial Infarction with onset of symptoms > 15 minutes and < 12 hours *ST Elevation in at least 2 contiguous leads of > 1 mm in chest or the limb leads or > 2mm in men / …
https://www.creehealth.org/sites/default/files/STEMI%20Thrombolysis%20Protocol%20STElevation%20MI.pdf
should be administered to STEMI patients with symptom onset within the prior 12 hours and ST elevation greater than 0.1 mV in at least 2 contiguous precordial leads or at least 2 adjacent limb leads. (Level of Evidence: A) 2. In the absence of contraindications, fibrinolytic therapy should be administered to STEMI patients with
http://www.mainecardiohealth.org/Pre-hospital%20STEMI%20Presentation%20-%20Russell.pdf
Duration of symptoms less than 12 hours ST elevation greater than 1 mm in two or more contiguous leads Ongoing symptoms - e.g., chest pain or shortness of breath Palpable lower extremity pulses Informed patient consent
https://nursingcecentral.com/lessons/initial-management-of-patients-with-stemi/
Reperfusion C hecklist for Evaluation of the Patient with STEMI . The following checklist covers the process for evaluating a patient to determine if fibrinolysis is indicated in the initial management of patients with STEMI (3).. STEP 1: Has the patient experienced chest discomfort for greater than 15 minutes and less than 12 hours?
https://resources.acls.com/free-resources/acls-algorithms/acute-coronary-syndrome
Once STEMI has been determined, start adjunctive treatments if indicated, but do not delay reperfusion. Time from onset of symptoms < 12 hours. If the time from onset of symptoms is 12 hours or less, proceed with reperfusion therapy. If the time from onset is greater than 12 hours, treat as a troponin elevated or high-risk patient. Reperfusion goals.
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