Management of acute STEMI
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A 46 years old clerk presented with central chest pain for 1 hour duration. This is his ECG. How are you going to manage the patient? Sir, the ECG shows an acute inferior ST elevation MI. This is a medical emergency. My task is to relieve the symptoms of the patient, stabilize him and reperfuse the ischemic muscle as quickly as possible. I will make sure that evaluation and management will happen simultaneously with minimal delay. I will immediately get the patient to an HDU and call my support staff to help me with the management. I will get them to attach the patient to a continuous cardiac monitor, check RBS, get blood for basic investigations and cardiac biomarkers and to insert a wide bore cannula while I'm evaluating the patient. I will assess his airway and then breathing paying specific attention to the presence of bibasal crepitations indicative of cardiac failure and oxygen saturation. If saturation is less than 90% I will start oxygen via face mask . I will a