ACLS Acute Coronary Syndrome Management

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ACLS Management of Suspected ACS

Initial Assessment and Recognition
- Evaluate patient presentation:
- Chest pain or pressure
- Shortness of breath
- Excessive sweating (diaphoresis)
- Obtain a thorough patient history:
- Previous cardiac events
- Risk factors for heart disease
- Assess vital signs rapidly:
- Pulse, respiration rate, blood pressure, temperature, oxygen saturation (SpO2)
- Maintain SpO2 at or above 94% using low-flow oxygen via nasal cannula
- Monitor for hemodynamic instability

Immediate Interventions
- Administer 324 mg of chewable aspirin if no contraindications exist:
- Reduces platelet aggregation and thrombus formation
- Administer 0.4 mg of nitroglycerin sublingually if systolic blood pressure is above 90 mmHg:
- Repeat every 5 minutes as needed
- Dilates coronary arteries to alleviate chest pain
- Confirm no recent use of phosphodiesterase-5 inhibitors

Immediate Interventions
- Obtain a 12-lead ECG promptly:
- Identify ST-segment elevation myocardial infarction (STEMI) or other changes
- Establish intravenous (IV) access for medication and fluid administration
- Collect blood samples for testing:
- Cardiac biomarkers (troponin)
- Complete blood count
- Basic metabolic panel

Continuous Monitoring and Further Management
- Check vital signs every 5 minutes:
- Assess treatment effectiveness
- Detect changes in patient condition
- Address ongoing chest pain:
- Use additional doses of nitroglycerin or suitable analgesics

Continuous Monitoring and Further Management
- Evaluate for fibrinolytic therapy or primary percutaneous coronary intervention (PCI):
- Based on ECG findings and local protocols
- Expedite transfer to a cardiac catheterization lab if indicated
- Transfer stabilized patients to a cardiac care unit for continuous monitoring

Key Considerations
- Time is critical to minimize myocardial damage:
- Rapid assessment and intervention are essential
- Ensure effective communication and coordination among ACLS team members
- Provide patient education:
- Information about acute coronary syndrome
- Treatment options
- Lifestyle modifications

Conclusion
- Adherence to ACLS guidelines improves patient outcomes
- Prompt intervention is vital for minimizing myocardial damage
- Ongoing education and practice are necessary to maintain competency in ACS management
Category
Cardiology
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