ACLS Fibrinolytic Checklist
ACLS Fibrinolytic Checklist
General Items
- Educate patient and family about procedure and possible side effects
- Document all findings and interventions in patient record
Patient Assessment
- Confirm diagnosis of ST-Elevation Myocardial Infarction (STEMI)
Indications for Fibrinolysis
- Patient is within 12 hours of symptom onset
- ST-segment elevation > 1 mm in two contiguous leads
- No contraindications to fibrinolytic therapy
Contraindications to Fibrinolysis
- Active bleeding or bleeding diathesis
- History of intracranial hemorrhage
- Known structural cerebral vascular lesion or tumor
- Recent surgery or trauma (within 3 weeks)
- Severe uncontrolled hypertension (BP > 180/110 mmHg)
- Pregnancy or postpartum (within 2 weeks)
Fibrinolytic Administration
- Select appropriate fibrinolytic agent (e.g., alteplase, tenecteplase, reteplase)
- Obtain IV access (preferably large-bore, antecubital vein)
- Administer fibrinolytic agent according to protocol
- Monitor patient for signs of reperfusion and bleeding
Post-Fibrinolysis Care
- Obtain ECG to assess for ST-segment resolution
- Monitor vital signs closely
- Initiate antiplatelet and anticoagulant therapy as indicated
- Assess for complications (e.g., re-occlusion, bleeding)
Generated from Panda Checklist
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