Emergency Department Management of Patients Needing Reperfusion Therapy for an ST-Segment Elevation Acute Myocardial Infarction
Publication Date: June 1, 2017
Last Updated: March 14, 2022
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
American College of Emergency Physicians
Publication Month/Year
June 1, 2017
Last Updated Month/Year
August 2, 2023
Supplemental Implementation Tools
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, nurse, nurse practitioner, physician, physician assistant
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.]
Methodology
Number of Source Documents
684
Literature Search Start Date
January 1, 2006
Literature Search End Date
January 10, 2017