Acute ischemic syndromes. Early response.
The optimal treatment of patients with AIS depends on a well-run, integrated system of care involving patients and teams of health care professionals. It begins with patient education and extends to a method for accessing an efficient and effective EMS system. Medics must be well equipped and well trained to evaluate and begin initial treatment during prompt transport to an appropriate hospital. The role of out-of-hospital 12-lead ECGs and thrombolysis is reviewed and may be appropriate for some EMS systems. The initial evaluation and treatment in the ED goes on simultaneously and is a dynamic process. Prompt treatment with oxygen, nitroglycerin, morphine, and aspirin is indicated. Initial risk stratification is based on the first ECG, cardiac biomarkers, and the clinical history and physical exam. Disposition and further evaluation is individualized according to the initial work-up and risk assessment.
Vanlandingham
Benjamin D
BD
Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
Sanders
Arthur B
AB
D000208:Acute Disease; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000592:standards* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000517:prevention & control / Q000628:therapy; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D010347:Patient Care Planning / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods; D011361:Professional Competence; D015996:Survival Rate; D013997:Time Factors; D017749:Total Quality Management; D014218:Triage