ACS Management

1. ABDCE assessment

2. 12 lead ECG 

  • If STEMI urgent referral to Cardiology for possible primary PCI

3. Blood tests including Troponin, renal function, electrolytes, full blood count, VBG/ABG 

  • Troponin T and I, are proteins found in cardiac muscle. When the muscle is damaged Troponin is released into the blood stream. They are very sensitive and specific markers of cardiac injury. Elevated levels in the bloods are abnormal (normally undetectable).

4. Ensure patient IV access

5. Treat pain with Glyceryl Trinitrate (GTN) and/or opiates such as Morphine. Caution with GTN if the patient is hypotensive.

6. Oxygen if needed to maintain target oxygen saturation

7. Aspirin 300mg orally

8. Consider continuous monitoring and echocardiogram

9. Referral to Cardiology

Stop and think!

Patients with an ACS are at greater risk of cardiac arrhythmias, they need to be closely monitored.