STEMI Application. Template for MDH employees 2025

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STEMI stands for ST Elevation Myocardial Infarction. On a heart tracing there is a particular area that is called the ST segment. When this segment is elevated, the person is said to have a STEMI. All STEMI patients in Fraser Health are transported to Royal Columbian Hospital for STEMI treatment.
I use the PAILS mnemonic (P-posterior A-anterior I-inferior L-lateral S-septal): ST elevations in one set of leads has reciprocal changes in the leads of the next letter.
ing to the American College of Cardiology/American Heart Association guidelines for STEMI, there must be new ST segment elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV) in men or 1.5 mm (0.15 mV) in women in leads V2-V3 and/or of 1 mm (0.1 mV) in other contiguous chest leads or the
Immediate management: Use the ABCDE approach, continuous monitoring, and provide analgesia, aspirin loading dose (300mg), and oxygen if SpO2
STEMI: ST-segment elevations 1 mm (0.1 mV) in 2 anatomically contiguous leads or 2 mm (0.2 mV) in leads V2 and V3 or new left bundle branch block and presentation consistent with ACS. If ECG suspicious but not diagnostic, consult cardiologist early.
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Remember the PAILS mnemonic when assessing for reciprocal changes. PAILS stands for P-posterior A-anterior I-inferior L-lateral S-septal. ST elevations in these leads most commonly create reciprocal ST depressions in the corresponding leads of the next letter in the mnemonic.
Guidelines recommend percutaneous coronary intervention (PCI) as the gold standard treatment within 90 minutes from first clinical contact,1 or thrombolysis within 30 minutes where timely PCI is not achievable.
Use the MONA mnemonic: Morphine, Oxygen, Nitrates, Aspirin.

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