Research and Justify the Best Practice Pre-Hospital Management of a Myocardial Infarction.

Research and justify the best practice pre-hospital management of a myocardial infarction.

Myocardial infarction (MI) occurs when a blood clot blocks or near blocks the coronary artery thereby causes any muscle which is supplied by this artery to die (NICE guidelines, 2013).   Mortality rates have fallen in the United Kingdom during the last 30 years from 20% to 5% which may be due to improved drug therapy and speed of access to effective treatments (NICE, 2013).
Symptoms of a MI (Caroline 2006) |
Central chest pain, constricting in nature, may radiate to left arm and neck | Women and diabetics may not show these signs (Gregory and Ward, 2010) |
Nausea and vomiting, clammy and cold to touch | |
Feeling impending doom | |

The Department of Health (DoH) published the National Service Framework for Coronary Heart Disease (NSF-CHD) in 2000.   This paper introduced protocols and standards for anyone treating MI’s to ensure that everyone country wide received the best optimum treatment.
Pre hospital best practice treatment for any patient suspected of having a MI is:
  * Scene safety
  * Personal protection
  * Having defibrillator and   equipment to hand
  * Overall general impression of the patient
  * Assessing and correcting airway, breathing, circulation and disability using the stepwise guidelines in Joint Royal Colleges Ambulance Liaison Committee (JRCALC) guidelines (Fisher, Brown and Cooke, 2006)
  * Pain scoring using OPQRS
  * Electrocardiogram (ECG)
  * Baseline observations – To be repeated throughout transportation to hospital at regular intervals
Caroline (2006, p. 27.29) says that any “middle aged or older patient” complaining of chest pain, treatment should be started at once on arrival, “even before you have completed any patient history and physical examination.’   The pre hospital goals of chest pain are to ensure that the patient is quickly relieved of pain and apprehension, thereby reducing the chances of serious...