文档介绍：急性心肌梗死的急救处理
张健
北京军区总医院心肺血管病中心
CONTENTS
常规治疗
溶栓治疗
PCI
并法症的治疗
早期危险评估和二级预防
特殊类型心肌梗死
年轻人心肌梗死
康复治疗
常规治疗 -- Pre-hospital Tasks
Education 硝甘 3片 5分钟“120”“999”
EMS paramedics
Pre-hospital Trombolysis door –to-needle
< 30min
常规治疗 -- Tasks in ER
Initial Evaluation within 10min
Confirmed Diagnosis within 20min
Door-to-needle within 30min
Door-to-Balloon within 90min
D2B – D2N >60min Thrombolysis
Chest Pain Center
常规治疗 -- Tasks in ER
Electrocardiography intepretetion within 5min
常规治疗 -- Tasks in ER
Cardiac Markers
myoglobin 2h
cTnI,cTnT 4h
CK-MB 8h
常规治疗 -- Tasks in ER
Echocardiography
“Segmental”
rather than “Global”
常规治疗 -- Tasks in ER
Nuclear Cardiology
常规治疗 -- Tasks in ER
ER procedures
“ Transferring should be taken into account”
常规治疗 -- 住院后的治疗
General Procedures (1)
1 IV line
2 Oxygen and Oximetry blood gas
3 Relief of fort a sublingual nitro
b intraveous nitro
c morphine sulfate
d beta-blockers
e ACE inhibitors
4 Activity
5 diet
6 Bowel Care
7 Sedation
8 ECG monitoring
9 Laborotary studies
10 Adverse events monitoring