Cardiac Emergencies: St Elevation Myocardial Infarction (STEMi)

The given statement is true. Acute Coronary Syndrome (ACS) is indeed defined as patients experiencing symptoms such as angina, shortness of breath, chest, epigastric, arm, or jaw pain or discomfort. These symptoms may also be accompanied by diaphoresis, nausea, shortness of breath, or difficulty breathing. Therefore, the statement is correct.

If a patient cannot be delivered to a Cardiac Intervention Center within 45 minutes, it is necessary to complete a Fibrinolytic Therapy Checklist for STEMI (ST-elevation myocardial infarction) and transport the patient to the nearest Emergency Department (ED). This suggests that if the designated cardiac intervention center is not reachable within the specified time frame, it is important to initiate fibrinolytic therapy and provide immediate medical attention to the patient in the nearest ED. Therefore, the given statement is true.

If a patient does not meet the criteria for fibrinolytic therapy, it is important to consult with the nearest Cardiac Intervention Center and the nearest ED to determine the most appropriate receiving facility. This is because fibrinolytic therapy is a treatment option for certain types of heart attacks, and if the patient does not meet the criteria for this therapy, they may require alternative interventions such as cardiac intervention or emergency department care. Therefore, it is true that consultation should be done with the nearest Cardiac Intervention Center and the nearest ED in such cases.

The criteria for a STEMI on an EKG strip includes ST elevation greater than 1 mm in two or more contiguous leads and a QRS complex that is narrower than 0.12 seconds. Additionally, a posterior MI can be identified by ST depression greater than 1 mm in V1 and V2 with an R/S ratio of greater than equal to one and a narrow QRS complex. Lastly, a new left bundle branch block can be diagnosed if a previous EKG showed a narrow QRS complex and the current EKG shows a wide QRS complex. Therefore, all of the above criteria are used to determine a STEMI on an EKG strip.

Patients who meet the STEMI inclusion criteria should be transported to the closest Cardiac Intervention Center by air or ground as long as the delivery time is not more than 45 minutes greater than transport to the nearest ED. This means that if the transportation time to the Cardiac Intervention Center is within 45 minutes of the transportation time to the nearest ED, the patient should be taken to the Cardiac Intervention Center. This ensures that the patient receives timely and appropriate care for their condition.

Patients who present with inferior wall MI, clear lung sounds, and hypotension may be experiencing hypovolemia due to decreased cardiac output. Giving a fluid bolus of 250-500 mL of LR can help increase intravascular volume and improve blood pressure. Nitroglycerin is not the first-line treatment for hypotension in this case, as it primarily acts as a vasodilator and may further decrease blood pressure. Therefore, the correct answer is a fluid bolus of 250-500 mL of LR.

The Fibrinolytic Therapy Checklist for STEMI requires the patient to meet the following criteria: they must be 18 years or older, have signs and symptoms of STEMI, and cannot be delivered to a Cardiac Center within 45 minutes. These criteria are necessary to determine if a patient is eligible for fibrinolytic therapy, which involves the administration of medication to dissolve blood clots in the coronary arteries. The age requirement ensures that the patient is an adult, while the presence of STEMI symptoms indicates a potential heart attack. The inability to reach a Cardiac Center within 45 minutes suggests that immediate treatment is necessary and fibrinolytic therapy may be the best option in such cases.

The Fibrinolytic Therapy Checklist for STEMI includes several exclusion criteria that a patient must meet. These criteria include: active internal bleeding within the last 21 days, a known bleeding disorder, being within 3 months of intracranial surgery, serious head trauma, or stroke, being within 14 days of major surgery or serious trauma, having a history of cancer of the brain, experiencing a witnessed seizure at onset, and having a history of intracranial hemorrhage. These criteria are important to consider before administering fibrinolytic therapy to ensure patient safety and avoid potential complications.