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- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
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- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
- Here's some medication for the pain and to make sure the heart attack doesn't get worse
- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
- After identifying an anterolateral STEMI on the patient's ECG, I would transmit this to the receiving hospital. I would also recognise that I am a long way from hospital and determine whether I meet criteria for prehospital thrombolysis. Given that the time to hospital is <60 minutes, I would place an IV, administer 4,000u IV heparin and consider minimising interventions so as to not delay transport
- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
- The patient should be managed as per the Acute Coronary Syndromes CPG. I would begin by administering 300mg oral aspirin, 300mcg S/L GTN & 50mg transdermal GTN patch. 
- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
- I would then administer 50mcg IV fentanyl and 8mg IV ondansetron, making sure not to delay transport for these interventions as they can be achieved during transport
- Acute Coronary Syndromes, STEMI management, Pain Relief and Nausea & Vomiting
- I would ensure that I am not delaying transport for any reason and on the way to the nearest PCI centre, I would be reassessing the patient's pain, blood pressure, heart rate and repeating an ECG 30 minutes prior to arriving. 
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