Question

Providers need to be able to quickly assess patients with possible ACS, as the goal for patients with ST-Elevation Myocardial Infarction (STEMI) is to administer fibrinolytics within 30 minutes of arrival or PCI within 90 minutes of arrival. See the Acute Coronary Syndromes Algorithm resource document (CPRS & First Aid, n.d.). What improvements could be made, if any, to the design and structure of the EHR data system that could potentially improve care for patients with possible ACS, where minimizing delays is imperative to patient outcomes?

Answer 1

Usually standard guidelines recommend a door-to balloon time which is the time from the first medical contact to primary per cutaneous corknary intervention of less than 90minutes or 60 minutes for patients presenting with STEMI. Most people are unfortunate, as they do not recive mechanical reperfusion in the time frame. The current ESC guidelines give recommendation to tricagrelor, orasugrel and clopidogrel in the event of an ACS. But clopidrogrel is reserved for patients who is contraindicated with tricagrelor or prasugrel which makes the other two preferred antiplatelet agents. But Trricagrelor is indicated in patients with moderate ischaemic events. For parasugrel, it is indicated only in patients with ACS in whom the coronary is kown and is leading to PCI. But in ACcF guidelines it endorses both clopidogrel and and ticagrelor for patients with ACS without giving specific preference. But in cases where coronary anatomy is known all three agents are considered equivalent with no specific preference. This needs to be omproved