2015 Trumbull Memorial Hospital Demo

Chest Pain / STEMI Chest Pain / STEMI

Obtain a thorough OPQRST and SAMPLE. Remember other pertinent symptoms: SOB, nausea, vomiting, sweating, pale/ashen skin, past history of cardiac disease.

EMTs may assist patient with their prescribed Nitro.

Universal Patient Assessment

Oxygen Titrate SpO2 to 94%

< 15 minute scene time ideal with 12-Lead performed within 5 minutes of patient contact

Cardiac Monitor 12-Lead ECG If EMT or STEMI, transmit

When giving report to receiving facility, start

Any suspected inferior STEMI receives a right sided 12-Lead

conversation by identifying your unit, and say “I have a STEMI,” then explain why.

Aspirin 324 mg PO

Suspected Inferior STEMI

Other Cardiac Chest Pain/STEMI

Systolic BP >100mmHg Patient appears hemodynamically stable.

Nitro Paste 1” or

Nitro Tab 0.4mg SL EMT Call-In Order Repeat tab every 3 min Withhold if BP <100mmHg Systolic

Yes

No

Rapid Transport

Rapid Transport

Adult IV/IO

Adult IV/IO

Adult IV/IO

Fluid Boluses as necessary to maintain perfusion Monitor for pulmonary edema

Withhold if pulse <70bpm Nitro Paste 1” or Nitro Tab 0.4mg SL EMT Call-In Order Be prepared for hypotension May repeat tab once

Consider Fentanyl 50mcg IV/IO

12

EMR

EMT

AEMT

Paramedic

Extended