The plan of care for a patient with a STEMI, treated in a non-percutaneous coronary intervention capable (PCI) hospital, includes:
A) evaluation in the cardiac catheterization lab within 90 minutes of non-PCI hospital arrival.
B) transfer to a PCI-capable hospital within 3 hours.
C) fibrinolytic therapy if transfer causes a delay of more than 120 minutes for door to balloon.
D) stabilizing patient for 24 hours, then transferring to a PCI-capable hospital.
C) fibrinolytic therapy if transfer causes a delay of more than 120 minutes for door to balloon.
Explanation: A) If first seen at a non-PCI-capable hospital, the patient should be transferred quickly so that the time from door to balloon is no more than 120 minutes.
B) If first seen at a non-PCI-capable hospital, the patient should be transferred quickly so that the time from door to balloon is no more than 120 minutes.
C) Unless contraindicated, the patient who arrives at non-PCI-capable hospital with a STEMI should receive fibrinolytic therapy if the transfer is expected to cause a delay of more than 120 minutes for door to balloon. If medical therapy is chosen as the reperfusion strategy, it should be administered within 30 minutes ("door to drug") of the patient's arrival at the hospital.
D) If first seen at a non-PCI-capable hospital, the patient should be transferred quickly so that the time from door to balloon is no more than 120 minutes.
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