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
