what are currnet standards of care for chest pain and acs in emergency room?

Answer 1

when I took my hubby for chest pains they sent him through triage and then took him straight back hooked him up to a EKG. checked his legs for swelling and asked him to describe the pain.

There was nothing wrong thank heaven. The doctor explained what to look for and set us up with a doctor for further testing.

Answer 2

I am a paramedic and within OUR protocols, we do a variety of things. Cardiac monitor, pulse ox, oxygen, morphine, nitro, aspirin. Depending on what symptoms the patient presents with, we may also administer something for hypertension if the blood pressure is elevated, although 2 of the first-line ACS drugs I already mentioned - morphine and nitro - tend to lower blood pressure as a side effect. If the patient has an arrhythmia, he/she may be treated with an anti-arrhtymic suitable to the particular problem. In the ED, all of these things are done, as well as chest x-ray, labs to measure cardiac enzyme levels, and the patient may be started on an IV drip of Heparin and Integrillin and possibly nitro, depending upon his/her pain level and blood pressure. If the patient's blood pressure is low, there are a variety of vasopressors that could be used - one of the most common is dopamine. Depending upon the length of time since the patient's symptoms began, he/she may also receive TNK, or a drug to "bust" the clot that is causing the heart attack. Many of these patients will wind up getting a cardiac catheterization, which is a procedure that allows the docs to take a look at the coronary ateries and determine which one/s are blocked.

The thing to keep in mind is that while many components of treatment for ACS are standard, many are also going to vary depending upon the patient's condition. Not every heart attack is the same, and not evey similar heart attack produces the same symptoms in every patient. Hope this helped.