What is the ACS Protocol for a person suffering from acute chest, he is diabetic and hypertensive too?

Answer 1

This is a very vast practical question, however I will write the basics:
Treatment :
Pain Killer in I/V form.
O2 Inhalation
Nitrolingual.
I/V Nitrates e.g.Isoket @10 drops / minute keeping BP in view.
Clot blasters (SK) if necessary.
Control BP and Diabetes followed by blood thinner.
Standby for any surgical cardiac intervention from stent to cardiac transplant.
Hospitalization till patient is out of danger.
Investigations:
Trop T or tropinin I (repeat if necessary)
Continuous EKG monitoring.
Cardiac Enzymes.
CT scan.

Answer 2

Hey there Winter Lion! Not sure I'm buying into all the answers you've gotten so far. How long has this person had diabetes? What kind of medications is the person on and are they keeping the hypertension and diabetes in control? Oxygen and nitroglycerin are certainly a part of the protocol. Probably a beta-blocking drug like lopressor. The dose of that would depend on how they presented at the hospital...and I'm assuming that this person is there by now!!! If things are pretty hot and heavy there they may give 3, 5mg IV pushes of it. If the patient is somewhat stable at the time they may give it in pill form. This drug is great for reducing the stress and excitability of the heart both in the acute phase and as a long term treatment. If there are some changes on the EKG then it may warrant a quick trip to the cath lab to take a look and see what, if any blockages there are. Diabetes is tricky in heart disease. It can block some of the pain so if a long term diabetic is having chest pain it can be really serious. Normally they don't have the typical type of pain because their pain receptors aren't working right.

Morphine is a part of the heart attack protocol but I'd try the nitro and lopressor (metoprolol) first. Morphine can mask problems sometimes.

Answer 3

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Answer 4

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Answer 5

If you were just hypertensive I'd say a beer a day actually. Why? Harvard did a study - so did the AHA - and people with heart issues / high blood pressure actually respond quite well to LOW (one beer per day, one shot per day) daily alcohol consumption.. As a matter of fact, so do healthy people. The diabetes thing though.. I would not drink at all. Especially not beer. Beer has too many calories and too much simple carbs in it for a diabetic.. But if you have to drink anything, I would suggest something like a half shot / threefourths shot of vodka (not rum, not tequila, not a liqueur) mixed in a NO-SUGAR drink (like diet soda) twice maybe three times a week. Before I'd make your alcoholic drink a regular thing though, I would test to see how your sugar levels respond to it like the person before suggested. If you respond badly, I'm sorry, tough break.. You asked is wine better? For someone with heart issue yes. For you, with diabetes, again.. SUGAR IS BAD :)

Answer 6

saline IV fluids, sublingual nitro and transport to hospital asap.
In hospital, oxygen, elevate head of bed, ms 2mg IV for pain, EKG and draw cardiac chem panel, monitor.