Chest pain & STEMI

While on the decline, coronary artery disease (CAD) is a leading cause of death in the US. CAD can present itself as acute coronary syndrome (ACS) with patients, showing signs and symptoms of myocardial ischemia or infarction.

ACS is divided into three subsets:

• Unstable angina (UA)
• Non-ST segment elevation myocardial infarction (NSTEMI)
• ST-segment elevation myocardial infarction (STEMI)

Pre-hospital care guidelines

Aurora South WI EMS has several pre-hospital care guidelines to help you manage patients with ACS. STEMI patients require immediate catheterization to open the blocked vessel and should be taken to the closest facility with these capabilities.

• Chest Pain/Acute Coronary Syndrome (ACS) [PDF]: Pre-hospital provider protocol for patients experiencing chest pain, Acute Coronary Syndrome or STEMI (ST Elevation Myocardial Infarction).
• Cardiac Arrest [PDF]: Pre-hospital provider protocol for patients in cardiac arrest, including the MCMAID sequence.
• Hypotension or Shock[PDF]: Cardiogenic shock definition and pre-hospital provider protocol, including dopamine drip dosing chart.
• Termination or Withholding Resuscitative Efforts [PDF]: Guidelines for deciding to withhold or withdraw resuscitative efforts, including DNR orders, living wills, and circumstances that may impact care.

Resources

EMS World STEMI 2.0 (Issue February 2018) – Learn more about STEMI and its related syndromes and equivalents.