Last updated January 13, 2022

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

Recommendations

Patient Management

Fibrinolytics may be administered to patients when door-to-balloon (D2B) time is anticipated to exceed 120 minutes. (B)
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A dose reduction should be considered when administering fibrinolytics to patients aged 75 years or older. (C)
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To decrease the incidence of major adverse cardiac events (MACE), patients with STEMI should be transferred to a PCI-capable hospital as soon as possible. (B)
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Because safety has not been established, clinical judgment should be used in deciding whether to provide or withhold morphine in patients undergoing reperfusion therapy. (C)
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Recommendation Grading

Overview

Title

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

Authoring Organization

Publication Month/Year

June 1, 2017

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

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

Paramedic emt

Scope

Assessment and screening, Management, Treatment

Diseases/Conditions (MeSH)

D000072657 - ST Elevation Myocardial Infarction, D015424 - Reperfusion, D004635 - Emergency Medicine, D015425 - Myocardial Reperfusion

Keywords

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

Source Citation

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