Recommendations

Document Overview

Design and created by Guideline Central in participation with the American College of Emergency Physicians.

Emergency Department Management of Patients Needing Reperfusion Therapy for an ST-Segment Elevation Acute Myocardial Infarction

American College of Emergency Physicians

Publication Date: Jun 1, 2017

Page Last Updated: May 5, 2026

American Physical Therapy Association Evidence Grading System

Grade of Evidence
Grade	Recommendation	Description
A	Strong	A preponderance of level I and/or level II studies supports the recommendation, This must include at least 1 level I study.
B	Moderate	A single high-quality randomized controlled trial or a preponderance of level II evidence supports the recommendation.
C	Weak	A single level II study or a preponderance of level II and TV studies supports the recommendation.
D	Conflicting	Higher-quality studies conducted on this topic disagree with respect to their conclusions. The recommendation is based on these conflicting studies.
E	Theoretical/foundational	A preponderance of evidence from animal or cadaver studies, from conceptual models/principles or from basic science/bench research supports this conclusion.
F	Expert opinion	Best practice based on the clinical experience of the guidelines development team.

Document Overview

Document Title: Emergency Department Management of Patients Needing Reperfusion Therapy for an ST-Segment Elevation Acute Myocardial Infarction

Authoring Society: American College of Emergency Physicians

Document Publication Date: Jun 1, 2017

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.doi.org/10.1016/j.annemergmed.2017.09.035

Source Citation: [Ann Emerg Med. 2017;70:724-739.]

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: Provide guideline of Emergency Department (ED) Management of Patients Needing Reperfusion Therapy for an STEMI

Scope: Assessment and Screening, Management, Treatment

Diseases/Conditions (MeSH)

D015425 - Myocardial Reperfusion

D004635 - Emergency Medicine

D015424 - Reperfusion

D000072657 - ST Elevation Myocardial Infarction

D015424 - Reperfusion

D004635 - Emergency Medicine

D015425 - Myocardial Reperfusion

Keywords: Reperfusion therapy, ST-elevation myocardial infarction (STEMI), STEMI

Target Patient Population: Adult patients presenting to the ED with suspected acute STEMI

Inclusion Criteria: Female, Male, Adolescent, Adult, Older Adult

Health Care Settings: Emergency Care

Intended Users: Nurse, Nurse Practitioner, Paramedic/EMT, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 684

Literature Search Start Date: Sunday, January 1, 2006

Literature Search End Date: Tuesday, January 10, 2017

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Emergency Department Management of Patients Needing Reperfusion Therapy for an ST-Segment Elevation Acute Myocardial Infarction

Recommendations

Patient Management

American Physical Therapy Association Evidence Grading System

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Provide guideline of Emergency Department (ED) Management of Patients Needing Reperfusion Therapy for an STEMI

Recommendation Development Processes & Methodology