Nursing care for STEMI patients : A 2 Case study

Abstract

ST elevated Myocardium Infarction: STEMI is a disease of high death rate and it is one of the five cause of death in Thailand due to occlusion of the blood flow in coronary artery. The goal of saving life is to make blood flow through coronary artery again as fast as possible STEMI patients will be early diagnosis and treatment : EKG time within 10 minutes and fibrinolysis time (SK) within 30 minutes after arrival.

Case study I : A thai man 45 years old who came to Singburi Hospital with present of chest pain refer to left shoudler 60 minutes piror. He had sent to emergency room by the FAST TRACK STEMI.  At that time he had checked for EKG, blood sample for cardiac enzyme :  He had diagnosed as inferior wall myocardial infarction and first medical treatment were MONAC and  SK. The fibrinolysis time was 29 minutes. After SK infusion his blood pressure was raised so he had NTG 1:10 V drip for control BP. After that he had sent for CAG.

Case study II : A thai female 48 years old who came to Community hospital with present of chest pain refer to left shoudler 40 minutes piror. At emergency room she had checked for EKG, blood sample for cardiac enzyme and her diagnosis was anterior wall myocardial infarction and  first medical treatment were MONAC and  SK. The fibrinolysis time was 29 minutes.  She had sent to Singburi Hospital by the FAST TRACK STEMI. After SK infusion she had severe complication : Intracerebral hemorrhage and refer for neurosurgery.

Finding and recommendation in case study, STEMI patients must be detected and treated as fast as possible by using the FAST TRACK STEMI. They must be closed monitoring during continuous infusion of Streptokinase. These can decrease complications and death rate.