Ppt on acute coronary syndrome protocol

Acute Oncology Initial Management Guidelines Adopted with Permission from United Kingdom Chemotherapy Redesign Group (UKCRG) Document Version 5.0 (Draft.

Acute Oncology Management Guidelines Initial Assessment Identify: All patients within 6/52 of chemotherapy specifically patients currently receiving 5Fluorouracil (5FU), Capecitabine and UFT Oral, which can cause coronary/ advanced disease If Neutropenic manage as per protocol Consider critical care management. All patients should/release syndrome, acute infusion reaction; syncope (rapid recovery) with bradycardia in vagal reaction; acute cardiac event; panic attack; acute severe asthma; acute abdominal /


Coronary Heart/Artery Disease

Most useful non-invasive procedure for evaluating the patient with angina. Standardized protocols utilizing exercise or medications are used to increase cardiac workload (or coronary blood flow)- see lecture on cardiac testing. Resting and stress ECG’s/see what is going on. Very easy to treat with nitrates and Ca blockers. Requires cardiac cath to diagnose. Acute Coronary Syndromes Unstable Angina (UA) Myocardial Infarction: MI: STEMI MI: NSTEMI There is considerable overlap between UA and NSTEMI./


2011 NH Patient Care Protocols Vicki Blanchard, BS, EMT-P Advanced Life Support Coordinator Tom D’Aprix, MD NH State Medical Director New Hampshire Department.

suctioning is discouraged Routine suctioning is discouraged  Newborn Resuscitation Initiate assisted ventilations on room air Initiate assisted ventilations on room air  Cardiac Protocols Administer oxygen to keep SpO 2 ≥ 94% Administer oxygen to keep SpO 2 ≥ 94% Basics  Acute Coronary Syndrome Transport suspected STEMI patients to closest facility that performs PCI Transport suspected STEMI patients to closest facility that performs PCI  Cardiac Arrest Great/


Acute Kidney Injury AKI - an abrupt increase in serum creatinine of at least 0.3 mg /dl or 1.5 over baseline over 48 hours (based on AKI Network Consensus.

physiologic goals reached quicker; hospital mortality reduced - 30% vs 45% Above protocol is the basis for Surviving Sepsis Guidelines Clin J Am Soc Neph 2010:733/acute interstitial nephritis, myeloma, hypercalcemia, hyperuricemia, tumor lysis syndrome, intratubular obstuction - uric acid, myeloma Glomerular - primary GN vs. secondary to a systemic disease Vascular - renal emboli, cholesterol emboli, vasculitis, anti-phospholipid syndrome, renal vein thrombosis Prediction of AKI after renal insult Coronary/


1 Acute Coronary Syndromes and the Role of Critical Pathway Christopher Cannon, M.D. Brigham and Women’s Hospital Boston.

al. Lancet 2001; 357: 995-1001 National Heart Attack Alert Program (NHAAP) CRITICAL PATHWAYS FOR THE TREATMENT OF PATIENTS WITH ACUTE CORONARY SYNDROMES 39 Critical Pathways - Definitions Standardized protocols for care Strict definition –Full list of all tasks, tracks variances Broader definition –Includes clinical protocols (NHAAP 4D’s) Diagnostic pathways - Chest Pain Centers Treatment pathways - Thrombolysis 40 Goals of Critical Pathways Increase use of recommended/


Dr. James Manos (MD) September 26, 2015 Overview: METABOLIC SYNDROME (insulin resistance syndrome, syndrome X)

continue to collect blood for up to 6 hours depending on the protocol requested by the physician. A variant is often used in pregnancy /the prevalence of the metabolic syndrome and of coronary heart disease (CHD) and cerebrovascular disease (CVD). The results showed that patients with the metabolic syndrome had significantly higher plasma /Niacin, particularly the time-release variety, at extremely high doses can cause acute toxic reactions. Extremely high doses of niacin can also cause niacin maculopathy on/


RISK STRATIFICATION IN ACUTE CORONARY SYNDROMES ADAM OSTER PGY-2 JANUARY 9, 2002 RESIDENT ORAL PRESENTATION.

RISK STRATIFICATION IN ACUTE CORONARY SYNDROMES ADAM OSTER PGY-2 JANUARY 9, 2002 RESIDENT ORAL PRESENTATION RISK STRATIFICATION IN ACS Objectives –Discuss the major risk stratification /and personnel for cardiac work-up –pre-hospital use –applicability to population subgroups Goldman Chest Pain Protocol Goldman et al. Prediction of the Need for Intensive Care in Patients Who Come to the Emergency Departments With Acute Chest Pain. New England Journal of Medicine. Vol 334. 1996. –Designed to predict the /


PROTOCOL UPDATE ALABAMA EMS PROTOCOLS EMT-INTERMEDIATE

.30 Suspected Spinal Injury 4.31 Syncope 4.32 Vaginal Bleeding 4.33 Vomiting and Nausea SECTION 4 TREATMENT PROTOCOLS CARDIAC ARREST 4.8 Under “Physical Assessment, Part B” changed “closed chest massage” to “chest compressions” to reflect current terminology CARDIAC SYMPTOMS/ACUTE CORONARY SYNDROME 4.10 Added wording to stress that women, diabetics, and all adult medical patients over the age of 50/


PROTOCOL UPDATE ALABAMA EMS PROTOCOLS PARAMEDIC EDITION 5 JUNE, 2010 UPDATE 1.

TITLE PAGE & TABLE OF CONTENTS TABLE OF CONTENTS UPDATED WITH CHANGES TABLE OF CONTENTS UPDATED WITH CHANGES –Added two new Patient Care Protocols 4.26 Respiratory Illness/Influenza 4.27 Respiratory Illness – Mass Casualty Emergency Renumbered: –4.28 Seizures –4.29 Shock –4/ category of Amiodarone (Cat. A) Corrected category of Amiodarone (Cat. A) 9 CARDIAC SYMPTOMS/ACUTE CORONARY SYNDROME 4.10 Added wording to stress that women, diabetics, and all adult medical patients over the age of 50 years have /


CORONARY ARTERY BYPASS Paul J. Corso, M.D., FACS, FACC Chief Cardiovascular Surgery, Washington Hospital Center.

day of Cardiac visit Erythropoetin administration: 40,000 U SQ weekly (caution in renal failure, cancer) In selected cases, acute Coronary syndromes may be stabilized with stenting culprit vessel and elective CABG/Hybrid approach Courtesy of Dr. Bridges PAH Cardiac Surgery Blood Conservation protocol Pre operative measures Avoid daily labs in the Inpatients awaiting surgery Serum Ferritin levels in all patients Bloodless Medicine will/


PROTOCOL UPDATE ALABAMA EMS PROTOCOLS PARAMEDIC EDITION 5 JUNE, 2010 UPDATE 1.

TITLE PAGE & TABLE OF CONTENTS TABLE OF CONTENTS UPDATED WITH CHANGES TABLE OF CONTENTS UPDATED WITH CHANGES –Added two new Patient Care Protocols 4.26 Respiratory Illness/Influenza 4.27 Respiratory Illness – Mass Casualty Emergency Renumbered: –4.28 Seizures –4.29 Shock –4/ category of Amiodarone (Cat. A) Corrected category of Amiodarone (Cat. A) 9 CARDIAC SYMPTOMS/ACUTE CORONARY SYNDROME 4.10 Added wording to stress that women, diabetics, and all adult medical patients over the age of 50 years have /


PROTOCOL UPDATE ALABAMA EMS PROTOCOLS EMT-BASIC EDITION 5 JUNE, 2010 UPDATE 1.

Bleeding –4.32 Vomiting and Nausea 4 SECTION 4 TREATMENT PROTOCOLS 5 CARDIAC ARREST 4.8 Under “Physical Assessment, Part B” changed “closed chest massage” to “chest compressions” to reflect current terminology Under “Physical Assessment, Part B” changed “closed chest massage” to “chest compressions” to reflect current terminology 6 CARDIAC SYMPTOMS/ACUTE CORONARY SYNDROME 4.9 Added wording to stress that women, diabetics, and/


2013 OEMS Prehospital Protocol Update Amy Gutman MD EMS Medical Director /

“trailing zeros” from medication dosing in all protocols, appendixes & drug references www.jointcommission.org /air Rationale: Hyperoxygenation causes coronary & systemic vasoconstriction, resulting in decreased coronary blood flow, increased coronary vascular resistance & free / 15 mins (pediatric) Rationale: Effective treatment for acute cyanide poisoning sanatate.bzi.ro O’Brien DJ, /” Added: “If suspect severe crushing injury / compartment syndrome, if injury permits” Rationale: To avoid contradicting new/


Management of Patients With Coronary Vascular Disease Question Is the following statement true or false? Individuals at highest risk for a cardiac risk.

, and if in the hospital setting, the ECG is being obtained. Administer oxygen Administer medications as ordered or by protocol, usually NTG. Anxiety Patients with Angina often fear loss of their roles within society and the family. They may/ruptures but the artery is not completely occluded. Unstable Angina and Acute MI are considered the same process but at a different point on the continuum. The term acute coronary syndrome includes unstable angina and MI. Clinical Manifestations and Diagnosis Chest Pain /


Management of Acute Decompensated Heart Failure Washington Metropolitan Society of Health-System Pharmacists September 28, 2013 Rockville Maryland David.

and ought not to be considered a stand-alone test. The Hospitalized Patient New Acute coronary syndrome precipitating HF hospitalization should be promptly identified by electrocardiogram and cardiac troponin testing, and /acute decompensated heart failure to receive furosemide administered intravenously by means of either a bolus every 12 hours or continuous infusion and at either a low dose (equivalent to the patient’s previous oral dose) or a high dose (2.5 times the previous oral dose). The protocol/


Coronary Artery Disease IMAD THULTHEEN KING SAUD UNIVERSITY.

perforation, abrupt closure, vasospasm n Acute MI n Dysrhythmias n Cardiac arrest n Restenosis of coronary artery n Bleeding or hematoma formation n/–Assess client’s tolerance –Inform physician –Administer anti-dysrhythmics as ordered or per protocol (Lidocaine, Atropine, Adenosine, Verapamil) –Defibrillation –Temporary pacing n Cardiogenic shock – / Indocin (indomethacin), ASA, ibuprofen, steroids –Administer analgesics n Dressler’s Syndrome –Form of pericarditis that occurs as late as 6 wks to months after/


ROSC! Now what??!! An EMS Guide to the Management of Post Cardiac Arrest Syndrome Jay Lance Kovar, MD, FACEP Montgomery County Hospital District PHI Air.

Survival Detail Pathophysiology of Post Cardiac Arrest Syndrome Discuss Monitoring, Therapeutic Strategies, and Protocols they apply to the Pre-Hospital Environment Propose Integrated EMS Protocols for Improved Intact Neurologic Survivability Background 1966 /Optimize Outcomes Persistent Pathology Precipitating or Contributory Pathology ACS AMI >50% OOH Adult Arrests 48% Acute Coronary Occlusion w/o apparent STEMI Biomarker Specificity Reduced yet 96% Sensitive for AMI Persistent Pathology Precipitating/


Providing Rapid Out of Hospital Acute Cardiovascular Treatment: PROACT-4 Justin A. Ezekowitz, Robert C. Welsh, Dale Weiss, Michael Chan, William Keeble,

(6.1)21 (6.9)0.690 ED visit or rehospitalization47 (16.0)59 (19.5)0.265 Per protocol analysis all non-significant differences Other results Adjudicated diagnosis Adjudicated Diagnosis Sub-categoryNFinal diagnosisn Angina 24Angina24 Acute Coronary Syndromes Unstable angina30Acute Coronary Syndromes 112 NSTEMI72 STEMI10 Acute Heart Failure 16Acute Heart Failure16 Other CardiovascularMyocarditis/Pericarditis2Other449 Pulmonary embolism3 Symptomatic aortic stenosis3 Significant arrhythmia19 Chest pain NOS 289/


Providing Rapid Out of Hospital Acute Cardiovascular Treatment: PROACT-4 Justin A. Ezekowitz, Robert C. Welsh, Dale Weiss, Michael Chan, William Keeble,

(6.1)21 (6.9)0.690 ED visit or rehospitalization47 (16.0)59 (19.5)0.265 Per protocol analysis all non-significant differences Adjudicated diagnosis Adjudicated Diagnosis Sub-categoryN Final diagnosisn Angina 24Angina24 Acute Coronary Syndromes Unstable angina30Acute Coronary Syndromes 112 NSTEMI72 STEMI10 Acute Heart Failure 16Acute Heart Failure16 Other CardiovascularMyocarditis/Pericarditis2Other449 Pulmonary embolism3 Symptomatic aortic stenosis3 Significant arrhythmia19 Chest pain NOS 289 Pulmonary/


1 2006 Protocol Update Central Shenandoah EMS Council.

EMT-Bs and all ALS providers. Therapy for acute coronary syndrome (ACS): –Emphasis on 12-lead ECG acquisition by EMT-Bs and all ALS providers. 12 Learn More… www.americanheart.org Click on… –CPR & ECC  AHA Guidelines for CPR & ECC www.americanheart.org Click on… –CPR & ECC  AHA Guidelines for CPR & ECC 13 2006 BLS Protocol Review CSEMS Council 14 Level Designation First Responder/


Cardiovascular Disease and the Patient with Diabetes and Metabolic Syndrome Nathan D. Wong, PhD, FACC, FAHA Professor and Director Heart Disease Prevention.

coronary disease 4 –From meta-analysis Without vascular disease39 With vascular disease19 HPS Collaborative Group. Lancet. 2003;361:2005-2016. Pyorala K, et al. Diabetes Care. 1997;20:614-620 Kearney PM Lancet;2008:371:227-239 Lipid Goals for Persons with Metabolic Syndrome/ CHS n = 2263 GAMI = Glucose Tolerance in Patients with Acute Myocardial Infarction study; EHS = Euro Heart Survey; CHS = /2008;9:29-38. D iabetes P revention P rogram: Protocol Design D iabetes P revention P rogram: Reduction in Diabetes/


Early high-dose Rosuvastatin for Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome The PRATO-ACS (Protective effect of Rosuvastatin and.

Contrast-Induced Nephropathy Prevention in Acute Coronary Syndrome The PRATO-ACS (Protective effect of Rosuvastatin and Antiplatelet Therapy On contrast-induced acute kidney injury and myocardial damage in patients with Acute Coronary Syndrome) Study Anna Toso, MD on/ post contrast medium (2400 mg/day) Nonionic, dimeric iso-osmolar contrast medium (Iodixanol) & Power injector (ACIST) Additional Protocol Details At discharge: Clopidogrel 75 mg/day, ASA 100 mg/day & Antiplatelet treatment: ASA (300 mg LD, 100/


University Hospital of Wales, Acute Coronary Syndrome (ACS)Unit. Innovation and Research-Innovative models of care. Victoria Williams Cardiology Nurse.

(UHW) To Describe and illustrate the development of the role through the establishment of a nurse led Acute Coronary Syndrome (ACS) service, demonstrating innovative ways of working to improve patient care. Learning Outcomes To illustrate the/approach between nursing staff, NPs & Medics Nurse-led discharge protocols. District General Hospitals Electronic referral within strict criteria Training and education re: ACS protocols Pre-operative workup and investigations Repatriation of patients awaiting follow on/


Tackling Coronary Heart Disease. Inequality in CHD services health outcomes how much? What is to be done? Population public health interventions.

CHD services health outcomes how much? What is to be done? Population public health interventions Services Population Smoking cessation High risk prevention Primary care clinics Acute coronary syndromes Quick hospital care Stable angina Ix and Rx protocols Revascularisation Protocols for Ix Targets for Rx Heart failure Community support Dedicated hospital clinics Rehabilitation Lifestyle interventions Education Inequalities Resources Health Action Zones Prevention or cure? Re-enforcing/


IV Heparin Baseline Angio Patient with Acute ST Elevation MI < 6 hours t-PA 80 mg / 3 hrs Streptokinase 1.5 MU / 60 mins Angio 10, 20, 30, 45, 60, 75,

, JAMA 1988;260:2849-2858 Rogers WJ, Circulation 1990;81:1457-1476 IV t-PA Heparin, ASA Randomize Pre-D/C ETT / RVG Acute MI < 4 hours onset : Conservative: Cath if +ETT or ischemia Primary Endpoint: Death or MI Follow-up 1 year Invasive: Cath 18/pharmacokinetics of the GP IIb/IIIa inhibitor RPR 109891 given IV and orally Protocol Design/Primary Results Giugliano RP, Am Heart J 2000;140:81-93 ASA 150-162 mg daily Patient with Unstable Coronary Syndrome <72 hours Orbofiban 50 mg BID Orbo 50 mg BID x 30/


Pierce County May 2011.  Introduce Washington’s new Emergency Cardiac and Stroke System  Review cardiac & stroke protocol guidelines  Review cardiac.

patient to unit III. Secondary Physical Exam & History A)Assess patient for signs and symptoms of Acute Coronary Syndrome  Be mindful of atypical presentations:  Weakness, dyspnea, AMS in elderly  Nausea, vomiting, weakness/Francis  NOTE: Madigan is not participating at this time  St. Elizabeth  Allenmore  St. Clare  St. Anthony (?) Prehospital protocol guidelines Triage tool Hospital levels I. Scene Size-Up/Primary Patient Assessment  Support ABCs  Check glucose, temperature, SpO2 (if possible) /


Guidelines for Integrated Care (Psychiatric & Medical) In the Community Module II: Metabolic Syndrome.

Mental Health What is Metabolic Syndrome? A group of conditions/factors that increase risks of heart disease and other acute or chronic medical conditions./ in coronary heart disease Cigarette smoking cessation = 50-70% decrease in coronary heart disease Maintenance of ideal body weight (BMI = 25) 35-55% decrease in coronary heart /and well-being (NASMHPD 2008) American Diabetes Association Recommendation Monitoring Protocols for Persons on Second Generation Antipsychotics Start4 wks8 wks12 wks3 mths12 /


Acute Myocardial Infarctions Howard L. Sacher, D.O. Chief, Division of Cardiology Adjunct Clinical Associate Professor of Medicine New York College of.

, aVL ST segment elevation and T wave changes occur first, then Q waves form Coronary syndromes have exploded since the early 1920’s The Progress of Atherosclerosis Foam cells – beginning/elevation decrease the mortality of a coronary event Those with a new onset LBBB has the worst Px Management Protocol No one thrombolytic has been shown / had improved survival with AICD. CHD really is worth preventing At the end….. The acute coronary event (AMI) can be devastating…as clinicians, let’s do our part to try/


An International Randomized Trial of Early Versus Delayed Invasive Strategies in Patients with Non-ST Segment Elevation Acute Coronary Syndromes TIMACS.

Trial of Early Versus Delayed Invasive Strategies in Patients with Non-ST Segment Elevation Acute Coronary Syndromes TIMACS Timing of Intervention in patients with AcuteCoronarySyndromes Funded by Canadian Institutes of /early intervention is superior to delayed intervention in patients with high risk non-ST segment elevation acute coronary syndrome TIMACSTIMACS Preliminary Results as of Nov 7, 2008 Design, Eligibility Criteria and Protocol UA or NSTEMI 2 of 3 Criteria: Age > 60, ischemic ECG or biomarker /


Major Bleeding is Associated with Increased One-Year Mortality and Ischemic Events in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary.

is Associated with Increased One-Year Mortality and Ischemic Events in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervetnion: The ACUITY Trial Steven V. Manoukian, Frederick Feit, Michele D/.org/inpress) Protocol definition: >3g/dL drop in Hgb, intracranial, retroperitoneal, 2U transfusion. Background and Methods: Major Bleeding in ACS and PCI Major bleeding is a significant complication of percutaneous coronary intervention (PCI) and acute coronary syndromes (ACS). Major/


Guidelines on the diagnosis and management of acute pulmonary embolism The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the.

with increased RV myocardial oxygen demand and decreased RV coronary perfusion gradient Both elements contribute to RV ischaemia and / something other than the modern gold standard of PE protocol CT scan Many echocardiographic abnormalities in patients with PE/ J Med 2008;359:2804-2813 ESC Guideline 2008: Acute Pulmonary Embolism European Heart Journal (2008) 29, 2276–/including recurrent DVT episodes and development of the post-thrombotic syndrome. Complications of permanent IVC filters are common, although /


2013 ACCF/AHA/SCAI Update of the Clinical Competence Statement on Coronary Artery Interventional Procedures A Report of the American College of Cardiology.

with and without onsite cardiac surgery) performing <200 cases annually must have stringent systems and process protocols with close monitoring of clinical outcomes and additional strategies that promote adequate operator and catheterization laboratory staff /From Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011;377:1409-20. Unadjusted/


DR SANDEEP R SR CARDIO 70 SLIDES

Abdominal - jaundice, right upper quadrant tenderness, and positive Murphy sign (acute cholecystitis). Vascular - postural hypotension and focal ischaemia (paradoxical embolus). /better donor availability Avoidance of cardiac allograft rejection Absence of coronary vasculopathy Management of Eisenmenger Syndrome Lung Transplantation Actuarial survival rates : At 1 year 70-/ non-ES recipients Ann Thorac Surg 2001;72:1887–91) TREATMENT PROTOCOL Eur Respir Rev 2009; 18: 113, 154–161 NEWER CONCEPTS IN/


THE IMPACT OF THE POSTOPERATIVE ‘FAST-TRACK’ PROTOCOL ON PATIENT MANAGEMENT AND OUTCOMES A Sharkey, P Braidley, N Briffa, G Cooper, S Forlani, D Hopkinson,

dependency unit Predictors of failure 1 Impaired left ventricular function with or without recent acute coronary syndrome Impaired left ventricular function with or without recent acute coronary syndrome ‘Re-do’ operation ‘Re-do’ operation Extracardiac arteriopathy Extracardiac arteriopathy Preoperative /fast-tracked If fast-tracking is not possible, fast-track protocols should be employed on CICU If fast-tracking is not possible, fast-track protocols should be employed on CICU Changes since this study Fast-/


1 What is… ?. 2 3 4 Disparities Among Women in Acute Cardiac Care Frances Canet, MD Cath Conference Thursday, May 26, 2011.

evaluation compared to men. 12 Evaluation Gender Disparities in the Diagnosis and Treatment of Non-ST Segment Elevation Acute Coronary Syndromes 2005 –CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of/gender of the provider, influences the delivery of cardiac care. Poor adherence to out-of-hospital chest pain protocols. 26 Disparities in Outpatient Care -Women were less likely than men to have low-density lipoprotein cholesterol /


General, Basic, Advanced & Paramedic Review. Overview  Methodology of Instruction  Stipulations  2015 Changes  The 2015 Protocol  Questions & Answers.

splinting to reduce pain as indicated  This protocol is for management of acute moderate to severe pain, it is NOT / Hypoglycemia  Hydrogen Ion (acidosis)  Hypothermia  Trauma  Thombosis  Toxins  Tamponade, (Cardiac)  Thrombosis, (Coronary & Pulmonary)  Tension Pneumothorax CA: Renal Dialysis  Calcium Chloride 10% (1,000 mg)  Calcium Chloride 10% 0/P-wave.  Sodium Bicarb 100 mEq IV  Sodium Bicarb 1mEq/kg IV Crush Syndrome Trauma 92 = EMR = EMT = AEMT = Paramedic Italics = MCP  Consider /


Major Bleeding is Associated with Increased 30-Day Mortality and Ischemic Complications in Patients with Non-ST Elevation Acute Coronary Syndromes Undergoing.

of Interest Statement Background: Major Bleeding in ACS and PCI Major bleeding is a significant complication of acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI). Recent data suggest that major bleeding is associated with an increase in adverse outcomes in/, Voeltz MD, Attubato MA, Lincoff AM, Chew D, Bittl JA, Wolski K, Topol EJ, Manoukian SV. Manuscript. Protocol definition: >3g/dL drop in HgB, intracranial, retroperitoneal, 2U transfusion. Moscucci M et al. Eur Heart J 2003;24/


Physiology and Protocol, Indications and Contraindications DN

coronary blood flow with exercise-supplydemand mismatch -ST segment changes 70-80%occlusion - detection by EST Sign CAD can exist with a -VE Exercise Stress Test. Treadmill protocol EST- stand protocols to progressively ↑ cardiovascular work load in a uniform and reproducible way Bruce protocol Naughton protocol Weber protocol/AS Uncontrolled symptomatic CCF Acute pulmonary embolus or /the following baseline ECG abnormalities: • Pre-excitation syndrome • Electronically paced ventricular rhythm • >1 mm /


Current State of Use of Evidence- Based Therapies for Acute Coronary Syndromes Strategies to Improve Implementation of Guidelines-Based Care Strategies.

Current State of Use of Evidence- Based Therapies for Acute Coronary Syndromes Strategies to Improve Implementation of Guidelines-Based Care Strategies to Improve Implementation of Guidelines-Based Care AHA/ACC /n 2,074 patients presenting with chest pain n Patients not undergoing urgent cardiac cath underwent standard Chest Pain Evaluation Protocol at Erlanger n Prospective Observational Study n 2,074 patients presenting with chest pain n Patients not undergoing urgent cardiac cath underwent standard Chest/


Aging Patient and AAFP. Which of the following statements about dementia and depression is true? A) Dementia is an etiology but depression is a syndrome.

patients with Alzheimer disease. The Clinical Antipsychotic Trials of Intervention Effectiveness protocol for Alzheimer disease assessed the effects of atypical antipsychotics on psychiatric/A. Patients on a strict vegetarian diet. B. Patients with coronary artery disease and high homocysteine levels. C. Patients with normal /allergic proctocolitis, food protein–induced enterocolitis syndrome, and oral allergy syndrome) Cutaneous reactions (i.e., acute urticaria, angioedema, atopic dermatitis, allergic /


S TABLE CORONARY ARTERY DISEASE YEDITEPE UNIVERSITY FACULTY OF MEDICINE PHASE 4 CARDIOLOGY COURSE 2014-2015 PROF. MUZAFFER DEGERTEKIN, M.D., PhD. MUSTAFA.

Acute Coronary Syndrome ST-Segment Elevation Myocardial Infarction Unstable Angina and Non–ST Elevation Myocardial Infarction D EFINITION Coronary artery disease: used to describe coronary arteries affected by a pathological process. the narrowing of the coronary arteries or blockage of coronary/(<5 METS) Prolonged ST-segment depression late into recovery Failure to complete stage II of Bruce protocol Failure to obtain HR >120/min (off negative chronotropic drugs) Exertional hypotension M YOCARDIAL P /


Coronary Vascular Disorder summer semester NUR 221.

syndrome characterized by episodes of discomfort (pain) or pressure in the anterior chest caused by insufficient coronary blood flow  Physical exertion or emotional stress increases myocardial oxygen demand, and the coronary/ rash n Anticoagulants –Heparin Given IV in acute situations or subcutaneous in non-acute situations Monitor partial thromboplastin time (PTT) Antidote /obtained.  Administer oxygen.  Administer medications as ordered or by protocol, usually NTG. n Anxiety:  Use a calm manner  Stress/


Impact of Platelet Reactivity on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease Dominick J. Angiolillo,

according to ACC definitions, and included cardiovascular death, ST-segment elevation myocardial infarction (STEMI), non-ST segment elevation acute coronary syndrome [non- STEMI (NSTEMI) and unstable angina (UA)], and stroke. 1 st 2 nd 3 rd 4 th/determined by assessing platelet surface expression of activated glycoprotein (GP) IIb/IIIa and P-selectin according to standard protocols. GP IIb/IIIa activation was assessed using a PAC-1 antibody and a polyclonal fluorescein isothiocyanate (FITC)-conjugated/


Acute Myocardial Infarction: Results from the DHMC Regional Registry Nathaniel Niles, MD Cardiology Grand Rounds January 13, 2005 Dartmouth-Hitchcock Medical.

4 5,10B TIM I 1,4 5,10B TIM I 1,4 5,10B CM Gibson 1998 in Acute Coronary Syndromes Sample Size of Pooled Analysis: 5,498 0 2 4 6 8 10 12 Epicardial Flow After Thrombolysis /, secure, registry interface On-line decision supportOn-line decision support Risk assessment toolsRisk assessment tools GuidelinesGuidelines Treatment protocolsTreatment protocols Regular feedback to participating ERs/hospitalsRegular feedback to participating ERs/hospitals STEMI patient outcomes overall and by treatment strategySTEMI /


Dallas 2015 TFQO: Darren Walters EVREVs: EVREV 1: Darren Walters COI #422 EVREV 2: Chris Ghaemmaghami COI #89 Taskforce: Acute Coronary Syndrome Fibrinolytic.

: EVREV 1: Darren Walters COI #422 EVREV 2: Chris Ghaemmaghami COI #89 Taskforce: Acute Coronary Syndrome Fibrinolytic therapy prior to hospital vs fibrinolytic after hospital arrival Dallas 2015 COI Disclosure (specific to/is the planned treatment strategy. In the prehospital setting, and should be administered by health care professionals using well-established protocols, competency training programs, and quality assurance programs, under medical oversight Dallas 2015 Risk of Bias in studies RCT bias /


Reversal Of Many Acute & Chronic Conditions With New Natural Therapies Presented by W. Lee Cowden, M.D. 2005 Nutramedix European Conference Hotel Palace.

Acute/ Syndrome,/Fatigue Syndrome, /acutely became ill with malaise, generalized muscle and /acutely/acute onset of influenza in 2004 in Bulgaria 15 patients with acute/Acute Food Poisoning 3 patients with acute food poisoning took Samento and within hours SYMPTOMS WERE CONTROLLED 3 patients with acute/coronary stenoses. 65 y.o. man with history of myocardial infarction complicated by cardiac arrest and multi-vessel tight coronary/acutely or chronically nor any unexpected side-effects./acutely/acute diseases. The Nutramedix herbals/


Developing a Chronic Disease Model of Care for Coronary Artery Disease and Depression in Rural Settings Dr Steve Bunker Prof James Dunbar Dr Prasuna Reddy.

. A model of care, incorporating a clinical pathway, will be developed to identify depressive symptoms in acute coronary syndrome (ACS) patients at the time of hospital discharge and eight weeks later when assessed in the primary/Chronic Disease Management: Depression and CHD Practice ProtocolNHFA Guideline Database Register of patients Periodic Recall Assessment by Protocol Database Audit of CHD Population Proposed intervention (modified from Rozanski*) SEVERE MODERATE MILD Stepped Interventions Degree /


Sripal Bangalore, M.D., M.H.A. Deepak L. Bhatt, M.D., M.P.H., F.A.H.A

College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography). Circulation 1999;99;2345-2357 Indications Patients With Unstable Acute Coronary Syndromes (Class I and III only) I I I I I I I I/asymptomatic patients after percutaneous transluminal coronary angioplasty (PTCA) or other surgery, unless as part of an approved research protocol B C C C Source: Scanlon PJ et al. ACC/AHA Guidelines for Coronary Angiography: Executive Summary and Recommendations/


Acute Stroke Slide Kit March 2012.

most common cause of death in developed countries, exceeded only by coronary heart disease and cancer 795,000 new or recurrent strokes occur /More up-to-date material Add stroke education Stroke Network Stroke networks and protocols are essential to ensure as many patients as possible are treated as quickly/nervous system (e.g. epileptic seizure, convulsion, aphasia, speech disorder, delirium, acute brain syndrome, agitation, confusion, depression, psychosis) often in association with concurrent ischaemic or /


Acute Stroke Slide Kit March 2013.

most common cause of death in developed countries, exceeded only by coronary heart disease and cancer Stroke in the US 795,000 new/Improve Optimisation of Stroke Patient Management - Networks Stroke Network Stroke networks and protocols are essential to ensure as many patients as possible are treated as quickly/ system (e.g. epileptic seizure, convulsion, aphasia, speech disorder, delirium, acute brain syndrome, agitation, confusion, depression, psychosis) often in association with concurrent ischaemic or /


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