Thrombolysis

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Diagnosis of ST Elevation MI and chest pain support. Charlie Bloe Clinical Ward Manager, CCU.

Acute CHD Presentations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acute Coronary Syndromes ST elevation MI Unstable Angina Non ST elevation MI

Atherosclerotic Plaque in Coronary Artery Lipid core Fibrous cap > Artery lumen Plaque rupture and thrombus formation

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The 12-lead ECG ,[object Object],[object Object],[object Object],[object Object]

The Six Limb Leads aVR aVL aVF Lead I Lead II Lead III N

Use the thoracic skeleton for landmarks The Chest Leads

Correct chest lead placement V1-V6 or C1-C6 V1 V2 V3 V4 V5 V6

6 + 4 = 12! ,[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],Anterior - septal MI: V1 – V4 Lateral MI: Lead I, aVL, V5, V6

Diagnosis of Acute Coronary Syndromes ,[object Object],[object Object],[object Object]

Normal ECG complex ,[object Object],[object Object],[object Object]

ECG evolution in acute STEMI ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Case Study (March 2010) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Raigmore ‘clot busters’ support team ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Impact on pre hospital thrombolysis (% of STEMI patients receiving PHT) Lots of myocardium saved!

Case study – Sept. 2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case study ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optimal Reperfusion Therapy. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

QIS standard for RACP (less acute chest pain) ,[object Object],[object Object],[object Object],[object Object],[object Object]

RACP clinic to date. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Thrombolysis

1. Diagnosis of ST Elevation MI and chest pain support. Charlie Bloe Clinical Ward Manager, CCU.

3. Acute Coronary Syndromes ST elevation MI Unstable Angina Non ST elevation MI

4. Atherosclerotic Plaque in Coronary Artery Lipid core Fibrous cap > Artery lumen Plaque rupture and thrombus formation

9. limb chest

10. The Six Limb Leads aVR aVL aVF N

11. The Six Limb Leads aVR aVL aVF Lead I Lead II Lead III N

12. Use the thoracic skeleton for landmarks The Chest Leads

13. Correct chest lead placement V1-V6 or C1-C6 V1 V2 V3 V4 V5 V6

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25. Impact on pre hospital thrombolysis (% of STEMI patients receiving PHT) Lots of myocardium saved!

26.

27.

28.

29.

30.

31.

32. Thank you.

Thrombolysis

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Thrombolysis