Thrombolytics for STEMI - Revision history

ClaireLewis: /* References */

2019-10-10T15:51:49Z

References

← Older revision		Revision as of 15:51, 10 October 2019
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	[[Category:Procedures]]		[[Category:Procedures]]
			[[Category:Cardiology]]
			[[Category:Pharmacology]]
			[[Category:Critical Care]]

ClaireLewis at 23:01, 1 October 2019

2019-10-01T23:01:35Z

← Older revision		Revision as of 23:01, 1 October 2019
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	*[[Chest pain]] >30 min but <12 hrs, not relieved by [[nitroglycerin]]		*[[Chest pain]] >30 min but <12 hrs, not relieved by [[nitroglycerin]]
	*PCI greater than 120 min away<ref> [AHA 2013 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction [https://www.heart.org/idc/groups/heart-public/@wcm/@mwa/documents/downloadable/ucm_453635.pdf PDF]</ref>		*PCI greater than 120 min away<ref> [AHA 2013 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction [https://www.heart.org/idc/groups/heart-public/@wcm/@mwa/documents/downloadable/ucm_453635.pdf PDF]</ref>
	*[[ECG]] criteria of STEMI		*[[ECG]] criteria of [[STEMI]]
	**STE in 2 contiguous leads		**[[ST elevation\|STE]] in 2 contiguous leads
	**Posterior STEMI		**Posterior [[STEMI]]
	**LBBB with Sgarbossa criteria		**[[LBBB]] with [[Sgarbossa criteria]]

	==Contraindications==		==Contraindications==
	===Absolute===		===Absolute===
	*Any prior [[ICH]]		*Any prior [[ICH]]
	*Known structural cerebral vascular lesion (AVM)		*Known structural cerebral vascular lesion ([[AVM]])
	*Known [[intracranial neoplasm]]		*Known [[intracranial neoplasm]]
	*[[Ischemic stroke]] within 3 mo		*[[Ischemic stroke]] within 3 mo
	*Active internal bleeding (excluding menses)		*Active internal [[hemorrhage\|bleeding]] (excluding menses)
	*Suspected [[aortic dissection]] or [[pericarditis]]		*Suspected [[aortic dissection]] or [[pericarditis]]

	===Relative===		===Relative===
	*Severe uncontrolled BP (>180/110)		*Severe uncontrolled [[hypertension\|BP]] (>180/110)
	*History of chronic severe poorly controlled hypertension		*History of chronic severe poorly controlled [[hypertension]]
	*History of prior ischemic stroke >3 mo		*History of prior [[ischemic stroke]] >3 mo
	*Known intracranial pathology not covered in absolute contraindications		*Known intracranial pathology not covered in absolute contraindications
	*Current use of anticoagulants with known INR >2–3		*Current use of [[anticoagulants]] with known INR >2–3
	*Known bleeding diathesis		*Known [[coagulopathy\|bleeding diathesis]]
	*Recent trauma (past 2 wk)		*Recent [[trauma]] (past 2 wk)
	*Prolonged CPR (>10 min)		*Prolonged [[CPR]] (>10 min)
	*Major surgery (<3 wk)		*Major surgery (<3 wk)
	*Noncompressible vascular punctures (e.g. IJ, subclavian)		*Noncompressible vascular punctures (e.g. IJ, subclavian)
	*Recent internal bleeding (within 2–4 wk)		*Recent internal bleeding (within 2–4 wk)
	*Patients treated previously with streptokinase should not receive streptokinase a 2nd time		*Patients treated previously with streptokinase should not receive streptokinase a 2nd time
	*Pregnancy		*[[Pregnancy]]
	*Active [[peptic ulcer disease]]		*Active [[peptic ulcer disease]]
	*Other medical conditions likely to increase risk of bleeding (diabetic retinopathy, etc)		*Other medical conditions likely to increase risk of bleeding (diabetic retinopathy, etc)

Rossdonaldson1: /* Complications */

2019-03-05T08:22:23Z

Complications

← Older revision		Revision as of 08:22, 5 March 2019
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	==Complications==		==Complications==
	#*0.5-1% of patients suffer [[ICH]]		*0.5-1% of patients suffer [[ICH]]

	==See Also==		==See Also==

Rossdonaldson1: /* Administration */

2019-03-05T08:22:15Z

Administration

← Older revision		Revision as of 08:22, 5 March 2019
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	==Administration==		==Administration==
			''If receive fibrinolytics also give anticoagulants for minimum of 48hr, and preferable the length of the hospitalization''
	{{Thrombolytics STEMI}}		{{Thrombolytics STEMI}}

Rossdonaldson1: /* Overview */

2019-03-05T08:22:00Z

Overview

← Older revision		Revision as of 08:22, 5 March 2019
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	==Overview==		==Overview==
	~~#*If receive fibrinolytics also give anticoagulants for minimum of 48hr, and preferable the length of the hospitalization~~		*Fibrinolytic treatment within 3hr resulted in >30 lives saved per 1000 patients
	#*Fibrinolytic treatment within 3hr resulted in >30 lives saved per 1000 patients

	==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==		==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==

Rossdonaldson1: /* Complications */

2019-03-05T08:21:44Z

Complications

← Older revision		Revision as of 08:21, 5 March 2019
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	==Complications==		==Complications==
			#*0.5-1% of patients suffer [[ICH]]

	==See Also==		==See Also==

Rossdonaldson1: /* Overview */

2019-03-05T08:21:35Z

Overview

← Older revision		Revision as of 08:21, 5 March 2019
Line 1:		Line 1:
	==Overview==		==Overview==
			#*If receive fibrinolytics also give anticoagulants for minimum of 48hr, and preferable the length of the hospitalization
			#*Fibrinolytic treatment within 3hr resulted in >30 lives saved per 1000 patients

	==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==		==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==

Rossdonaldson1: /* IndicationsACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdfRivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234...

2019-03-05T07:01:17Z

/* IndicationsACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdfRivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234...

← Older revision		Revision as of 07:01, 5 March 2019
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	==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==		==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==
	*[[Chest pain]] > 30 min but ~~less than~~ 12 hrs, not relieved by ~~NTG~~		*[[Chest pain]] >30 min but <12 hrs, not relieved by [[nitroglycerin]]
	*PCI greater than 120 min away<ref> [AHA 2013 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction [https://www.heart.org/idc/groups/heart-public/@wcm/@mwa/documents/downloadable/ucm_453635.pdf PDF]</ref>		*PCI greater than 120 min away<ref> [AHA 2013 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction [https://www.heart.org/idc/groups/heart-public/@wcm/@mwa/documents/downloadable/ucm_453635.pdf PDF]</ref>
	*[[ECG]] criteria of STEMI		*[[ECG]] criteria of STEMI
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	**Posterior STEMI		**Posterior STEMI
	**LBBB with Sgarbossa criteria		**LBBB with Sgarbossa criteria



	==Contraindications==		==Contraindications==

Rossdonaldson1 at 07:00, 5 March 2019

2019-03-05T07:00:52Z

@@ Line 1: / Line 1: @@
 ==Overview==
-==Indications==
+==Indications<ref>ACLS Training Center. Fibrinolytic Checklist for STEMI. https://www.acls.net/images/algo-fibrinolytic.pdf</ref><ref>Rivera-Bou WL et al. Thrombolytic therapy for acute myocardial infarction. Dec 08, 2015. http://emedicine.medscape.com/article/811234-overview*a3.</ref>==
-{{Thrombolysis indications and contraindications in STEMI}}
+*[[Chest pain]] > 30 min but less than 12 hrs, not relieved by NTG
 ==Contraindications==
 ==Administration==

Rossdonaldson1 at 06:59, 5 March 2019

2019-03-05T06:59:10Z

← Older revision		Revision as of 06:59, 5 March 2019
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	==Overview==		==Overview==


	==Indications==		==Indications==
			{{Thrombolysis indications and contraindications in STEMI}}

	==Contraindications==		==Contraindications==