PPCI (Leeds PPCI Pathway)

• Target: Door to balloon 90min
• Criteria:
  • Time: Chest pain within 12hrs (or worsened within 12hrs)
  • ECG:  ST elevation MI (1mm Limb or 2mm Chest leads) OR New LBBB. (Posterior MI do posterior leads and discuss with LGI)
• Actions:
  • Resuscitate
  • Contact PPCI team @ LGI (Mobile No. up in Resus)
  • Arrange blue light (P1) ambulance to LGI
  • Prasagrel 60mg if no previous CVA or Ticagrelor 180mg if previous CVA and Aspirin 300mg (if anti-coagulated Discuss with PCI team)
• Problems: 
  • Intubated patient: Often LGI would accept but need to arrange Cardiac ICU. If no bed patient could go for PCI to return locally immediately after PCI to our ICU’S?
  • LGI Full: Occasionally the cath lab is full and can’t accept your patient
    • Calling Manchester and Sheffield: It’s worth a go but they don’t have agreements with us  so having your patient accepted can be difficult
    • Don’t Forget Thrombolyisis: We need to open up the patients artery, if there is no quick decision to go for PPCI – Consider Thrombolysis

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