STEMI Protocols - page 2

by Medic2RN 10,801 Views | 12 Comments Senior Moderator

I need to ask the vast, smart ED nurses here...do any of you have a dedicated STEMI protocol sheet? I had a STEMI arrive via ambulance. I notified the Doc prior to arrival, grabbed out STEMI med box and got to work. The time... Read More


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    Grab the STEMI box, 362mg ASA to chew/down NG, 600mg Plavix PO, 4000 Units heparin IVP, metoprolol 25mg PO, nitro drip, NS @ 100 mL/hr, minimum 2 large bore IV, O2 @ 5-10 lpm via non-rebreather, shaved, pacer pads, cath lab 'clear' electrodes, multiple EKG's, out to cath lab, consented by cardiology. We strive to get them out of the ED no more than 20 minutes, if we have a heads up by EMS or local hospital without a cath lab. Team responds rather quickly, all cath lab team members have to live within 5 miles of hospital.

    We have a STEMI med sheet in our STEMI box, with all protocol meds in the box printed on the sheet, with info regarding dosage, admin, and time given. We scribble our notes on the back of the STEMI sheet and CPOE verbal order everything in FirstNet after we get them out. Since we are the only approved STEMI/Stroke alert facility within a 60 mile radius, we get quite a few of them, so we are all pretty used to it by now.
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    I appreciate everyone's input - thank you.
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    We have a folder with all the paperwork and protocols. The MD is responsible for the consent. When they try to fob it off on me I explain that I don't know all the possible complications, rates of complications and so on. They soon realize it is quicker for them to do it than argue with me about it.


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