The Macstrak Project ER Case Studies The following is a series of case studies to review different patient types and how they are captured on the form. The information is provided in sequence to reflect the natural progression of a patient’s care. As the case is presented, mark off the required information in the appropriate fields on your Macstrak form. At the end of each case study, the form will be reviewed with the correct answers supplied. If you have any questions, please refer to your Macstrak manual or contact us at the Macstrak Project Office.

The Macstrak Project ER Case Study

The Macstrak Project ER Case Study KFD is a 62 year old (9/9/43) woman with no significant past medical history.

The Macstrak Project ER Case Study KFD is a 62 year old (9/9/43) woman with no significant past medical history. On 08/2/06: 10:30KFD experiences chest pain while watching television.

The Macstrak Project ER Case Study 13:30Her husband drives her to the ER where she reports chest pain associated with nausea and diaphoresis. She is triaged at level II. 13:35Nursing assessment reveals persistent chest pain and her vital signs are as follows: BP is 145/80, HR is 96 and chest is clear.

The Macstrak Project ER Case Study 13:43Her first and diagnostic ECG is as follows: ST in leads II, III, a VFST in leads V 1-4 ASA and NTG S/L are given. 13:50ER MD assesses KFD and finds she has no contraindications to reperfusion therapy. The decision is made to treat KFD (weight 59 kg) with TNK. 14:0030 mg of TNK over 5 seonds is given. KFD also receives UF heparin IV and metoprolol IV. 15:00The pain persists and a repeat ECG shows persistent ST segment elevation.

The Macstrak Project ER Case Study 15:15KFD is transferred from your hospital to a tertiary centre for a PCI. 18:00The clerk calls the tertiary centre to check on KFD. She discovers KFD arrived at the cath lab at 16:00 and angiography confirmed a persistent occlusion of the RCA. She had a successful angioplasty with her first inflation at 16:35. This gave her time to rescue PCI of 155 minutes.

The Macstrak Project Centre: Date: 20 Day Month Year Patient Initials: F M L Birth Date: 19 Day Month Year Gender: Male Female ER Case Study KFD is a 62 year old (9/9/43) woman with no significant past medical history. K F D ER MACSTRAK X

The Macstrak Project Centre: Date: Day Month Year Patient Initials: F M L Birth Date: 19 Day Month Year Gender: Male Female ER Case Study KFD is a 62 year old (9/9/43) woman with no significant past medical history. On 08/2/06: KFD experiences chest pain while watching television. K F D ER MACSTRAK X

The Macstrak Project ER Case Study KFD experiences chest pain while watching television. X

The Macstrak Project ER Case Study Her husband drives her to the ER where she reports chest pain associated with nausea and diaphoresis. She is triaged at level II. X

The Macstrak Project ER Case Study Her husband drives her to the ER where she reports chest pain associated with nausea and diaphoresis. She is triaged at level II. X

The Macstrak Project VS at Presentation: VS Absent Systolic BP: Dyspnea/Rales: < 100 None Mild Mod/Severe >190 Heart Rate: < >100 ER Case Study Nursing assessment reveals persistent chest pain and her vital signs are as follows: BP is 145/80, HR is 96 and chest is clear. X X X

The Macstrak Project ER Case Study Nursing assessment reveals persistent chest pain. X X X X X

The Macstrak Project ER Case Study 10:30KFD experiences chest pain while watching television. 13:30KFDs husband drives her to the ER where she reports chest pain associated with nausea and diaphoresis. She is triaged at level II. 13:35Nursing assessment reveals persistent chest pain. 13:50ER MD assesses KFD and finds she has no contraindication to reperfusion therapy. 10:30 13:30 13:35 13:50

The Macstrak Project ER Case Study Her first and diagnostic ECG is as follows: ST in leads II, III, a VF ST in leads V 1-4 X X X

The Macstrak Project ER Case Study 13:43Her first and diagnostic ECG is as follows: ST in leads II, III, a VF ST in leads V :43

The Macstrak Project ER Case Study The pain persists and a repeat ECG shows persistent ST segment elevation. X X

The Macstrak Project ER Case Study ASA and NTG S/L are given. 30 mg of TNK over 5 seconds is given. KFD also receives UF heparin IV and metoprolol IV. X X X X

The Macstrak Project ER Case Study ER MD assesses KFD and finds she has no contraindications to reperfusion therapy. The decision is made to treat KFD (weight 59 kg) with TNK. 30 mg of TNK over 5 seconds is given. KFD also receives UF heparin IV and metoprolol IV. X X X X 30 1

The Macstrak Project ER Case Study KFD is transferred from your hospital to a tertiary centre for a PCI. X X X X 30 1 X X

The Macstrak Project ER Case Study 14:0030 mg of TNK over 5 seonds is given. KFD also receives UF heparin IV and metoprolol IV. 15:15KFD is transferred from your hospital to a tertiary centre for a PCI. 18:00The clerk calls the tertiary centre to check on KFD. She discovers KFD arrived at the cath lab at 16:00 and angiography confirmed a persistent occlusion of the RCA. She had a successful angioplasty with her first inflation at 16:35. This gave her time to rescue PCI of 155 minutes. 14:00 15:15 16:00 16:35

The Macstrak Project ER Case Study KFD is transferred from your hospital to a tertiary centre for a PCI. X

The Macstrak Project ER Case Study KFD is transferred from your hospital to a tertiary centre for a PCI. X

The Macstrak Project ER Case Study 15:15KFD is transferred from your hospital to a tertiary centre for a PCI. X 15:15