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QUOTE]Originally posted by greg c
NSTEMI- that's why he was going for an AM cath. [/QUOTE]
Its been a couple of years since I worked in ED so my memory is a little vague, but if I remember right we dont do Q wave or non-Q wave diagnosis anymore but ST elevation or non-ST elevation dx for intervention or thrombolitics (which arent in favor as much any more) for ACS.
A pt should be in cath lab within 90 minutes of hitting the door or 12 hours onset of symptoms.
Im not clear what IIb/IIIa therapy has to do with hx of previous stenting unless it has somehow failed and are trying to prevent further damage? In any case this pt would go right to cath lab too unless being transported from rural environment.
Ive seen a lot of integrillin used but mostly for cath pts and sometimes AMI.
In any rate someone will probably get their butt sued for letting their pt sit for AM cath...
I always rely on chest rise and auscultation to comfirm ETT (or other) placement. CO2 det are very nice but not gold standard. CXR is even better but of course not available prehospital-
ccrn
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