Improving Fire Service Response to STEMI

05/01/2009
By ANDREW P. MARDELLYour medic unit responds to a 45-year-old man with 30 minutes of rapid onset chest pain. The patient has a history of hypertension but no previous history of myocardial infarction (MI). He is also taking ramipril.You perform a 12-lead electrocardiogram (ECG), which demonstrates a three- to four-millimeter (mm) ST segment elevation in leads V1-V6 and no Q waves present (Figure 1). On examination, you find a regular pulse of 90 bpm, a blood pressure of 105/60 mm/hg, clear lungs, and normal heart sounds with no murmurs. You interpret the ECG as an impending anterior STEMI (ST-Elevation myocardial infarction) (anterior current of injury) and activate the catheterization la...

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