TAILIEUCHUNG - Ebook Prehospital management of acute STEMI: Part 2

This book examines various systems and policies for STEMI (ST-elevation myocardial infarction) care and triage prior to arrival at the catheterization laboratory. The purpose is to analyze the various strategies for prehospital STEMI management and weigh their pros and cons. With high variability in STEMI response systems in place across multiple countries, there is a need to determine which strategies are most effective. | ha t e 6 Prehospital STEMI Management in the Setting of Out-of-Hospital Cardiac Arrest Eric Wiel MPỊ PhEỊ and Patrick Goldstein MD INTRODUCTION Patients who have an out-of-hospital cardiac arrest OHCA in the course of their ST-segment elevation myocardial infarction STEMI represent a special subgroup of prehospital STEMI patients. In spite of much progress in cardiopulmonary resuscitation CPR the overall survival rate of OHCA is low with a long-term survival rate less than 7 .1 It has been estimated that 90 of OHCAs are due to acute myocardial 3 Only few data on patients with acute STEMI and prehospital CPR are It has been estimated that 10 to 21 of STEMI patients need defibrillation and A recent registry called Prehospital Myocardial Infarction Registry reported a 10 incidence of STEMI patients who underwent prehospital Patients with STEMI needing prehospital CPR constitute a subgroup of patients at very high risk for adverse events. The literature reports a high variability in outcomes in such patients due to differences in the definition of the event Prehospital Management of Acute STEMI Practical Approaches and International Strategies for Early Intervention 2015 Joseph S. Alpert Lynne T. Braun Barbara J. Fletcher Gerald Fletcher Editors-in-Chief Cardiotext Publishing ISBN 978-1-935395-66-9 131 132 Prehospital Management of Acute STEMI its etiology and the method and timing of coronary reperfusion therapy. Because primary percutaneous coronary intervention PPCI and fibrinolysis have demonstrated good outcomes in the first golden hours of STEMI without CPR the subgroup of STEMI patients who require CPR defined as high risk should benefit logically from such early and aggressive reperfusion However the role of coronary reperfusion strategies with thrombolysis or PCI in the subgroups of STEMI-OHCA patients remains unclear although an excellent prognosis of patients with STEMI has been globally reported in .

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• Prehospital management of acute STEMI
• Prehospital STEMI
• Prehospital Management
• Recommendations for improvement
• Current Programs—SAMU
• Progress of prehospital
• ECG acquisition
• STEMI specific interpretation
• Regional triage centers
• The increasingly important role
• Paramedic personnel