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12
EMR
EMT
AEMT
Paramedic
Extended
Chest Pain / STEMI
Chest Pain / STEMI
Universal Patient Assessment
Oxygen
Titrate SpO2 to 94%
Cardiac Monitor
12-Lead ECG
If
EMT
or STEMI, transmit
Aspirin
324 mg PO
Suspected Inferior STEMI
Other Cardiac Chest Pain/STEMI
Systolic BP >100mmHg
Patient appears
hemodynamically stable.
Adult IV/IO
Fluid Boluses
as necessary to
maintain perfusion
Monitor for pulmonary edema
Adult IV/IO
Withhold if pulse <70bpm
Nitro Paste 1”
or
Nitro Tab 0.4mg SL
EMT
Call-In Order
Be prepared for hypotension
May repeat tab once
Nitro Paste 1”
or
Nitro Tab 0.4mg SL
EMT
Call-In Order
Repeat tab every 3 min
Withhold if BP <100mmHg
Systolic
Adult IV/IO
Consider
Fentanyl
50mcg IV/IO
EMTs may assist patient with
their prescribed Nitro.
Obtain a thorough OPQRST
and SAMPLE.
Remember other pertinent
symptoms: SOB, nausea,
vomiting, sweating,
pale/ashen skin, past history
of cardiac disease.
< 15 minute scene time ideal
with 12-Lead performed within
5 minutes of patient contact
Any suspected inferior STEMI
receives a right sided 12-Lead
When giving report to
receiving facility, start
conversation by identifying
your unit, and say “I have a
STEMI,” then explain why.
Yes
No
Rapid Transport
Rapid Transport