#SimBlog: STEMI with VF Arrest
““56-year-old Caucasian male presented with severe central chest pain.””
Observations
A – Patent, self-maintaining
B – RR 24 SpO2 98%
C – HR 89, BP 177/107
D – GCS 15
E – Temp 35.1°C
Clinical findings
Pale
Diaphoretic
Pain score 10/10
Why we simulated?
As primary PCI has now become widely established as the treatment for ST elevation myocardial infarction (STEMI), the management of this condition has largely been removed from the Emergency Department. In hospitals like ours where there is no on-site PCI available it is imperative that patients are managed rapidly and efficiently to minimise any delay in transferring them to definitive care.
Further Reading:
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BMJ Best Practice – Diagnostic criteria for STEMI
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St Emlyn’s Blog – Minimising Door In Door Out (DIDO) time
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Resus Council UK – Adult Advanced Life Support (ALS) guidelines
Learning outcomes
In patients with STEMI it is a good idea to have the patient connected to the defibrillator.
Oxygen mask with reservoir bag needs connecting to 15 litres oxygen.
In high stress situations vocalising your thought processes can help keep all the team members in the loop and working towards the same goals.
Positive feedback
Good preparation with clear allocation of tasks prior to patient arrival.
Good team leading by staff nurse in ALS scenario.
Arrest to 1st shock delivered <2 minutes.
Good use of closed loop communication.
