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. Morphine for pain relief

6. Oxygen to maintain target oxygen saturation

7. Glyceryl Trinitrate (GTN) – avoid if hypotensive

8. Aspirin 300mg orally

9. Consider continuous monitoring and echocardiogram

10. Referral to Cardiology

Stop and think!

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