- See:
blunt cardiac trauma
- Initial Management:
-
determine whether the chest pain is of cardiac origin:
-
sublingual nitroglycerin should improve chest pain (at least partial relief) if the pain is of cardiac origin;
-
EKG changes in MI:
-
labs: CBC, cardiac enzymes (CPK q6 hours x 4 or cardiac troponin T & I);
-
optimize cardiovascular function:
-
nitrates can be given sublingually or topically before intravenous access is obtained;
-
arrhythmia
- hypertension:
- elevation of blood pressure should be managed with combination of nitrates,
beta blockers (
antihypertensive agents), and morphine;
- nitrates are the treatment of choice in patients who have hypertension with angina or myocardial infarction;
- beta-blocker therapy given IV at admission, reduces mortality & infarct size and is recommended;
- IV
labetalol and calcium-channel antagonists also reduce blood pressure while improving myocardial oxygenation.
- hypoxia: w/ decrease O2 sats, order
ABG, and give O2;
- anemia:
pRBC transfusion
-
monitoring: patient should be placed on a telemetry bed if one is available;
-
blood thinners and thrombolytics:
- begin thrombolytic therapy in combination with
aspirin and
heparin;
- Sequelae of MI:
- Outside Links:
-
GMO Manual
-
GMO Manual
-
Iowa Family Practice Handbook - 1
-
Iowa Family Practice Handbook - 2
-
Merck Manual
-
GMO Manual
-
Iowa Family Practice Handbook - 1
-
Iowa Family Practice Handbook - 2
-
Merck Manual
- References:
