Presentation PTCA
- 1. MELVIN PIOUS
- 4. Risk factor
- 5. Chest pain Severe and prolonged and may be described as crushing, constricting, or oppressive. Radiation of pain to ulner aspect of left arm, neck, jaw and Interscapular region. Clinical Manifestations
- 9. ASSESSMENT
- 10. 1. History Taking. 2. Physical Examination 3. Vital parameters 4. 12 lead ECG monitoring. 5. Measure oxygen saturation. 6. Obtain initial serum cardiac markers Nursing Assessment in Emergency Room
- 11. IMMEDIATE GENERAL MANAGEMENT 1. Oxygen at 4 l/min. 2. Aspirin 160-325mg. 3. Nitroglycerine SL or spray. 4. Morphine IV Memory Aid: ‘MONA’ NOW “ONAM”
- 12. 1.Assess and document the chest Pain. 2. Assess vital parameters. 3. Obtain 12 lead ECG. 4. Assess cardiac marker values. 5.Report the findings of assessment to physician. InterventionsInterventions
- 13. 6Administer oxygen, morphine sulfate, nitroglycerine or other medications as ordered. 7 Provide the restful environment and promote the patient’s comfort. 8 Provide care in calm, competent manner.
- 14. MEDICAL INTERVENTION Start two IV lines. Administer adjunctive medications:
- 16. Administer thrombolytic therapy as prescribed. Streptokinase Urokinase TPA(Tissue plasminogen activator) Door to drugs: <30min.`
- 17. Prepare for Primary PCI as prescribed. Door to balloon 90+ 30 min.
- 18. pROFILE • CBC, KFT, LFT, PT-INR, APTT, • VIRAL MARKER, • BLOOD GROUPING & Rh factor • RANDOM BLOOD-SUGAR • ECG , ECHO-Screening, CHEST X-RAY.
- 19. S OF PTCA