I am still confused (maybe just thick). Are we talking about patients in
whom you are finding ST elevation infarction, signs of cardiac ischaemia or
evidence of old infarction on the ECG.
Simon
Simon Carley
SpR in Emergency Medicine
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Evidence based emergency medicine
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----- Original Message -----
From: "Dunn Matthew Dr. (RJC) ACCIDENT & EMERGENCY - SwarkHosp-TR"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, April 19, 2002 12:51 PM
Subject: Re: Call to Door times; WAS: Coronary Heart
iseaseCollaborative( England)
> > Sorry, loose nomenclature on my part - would be more accurate
> > to talk of
> > atypical chest pain:
> >
> > " ... the presenting symptoms of acute myocardial infarction in the
> > elderly can be nonspecific. ... Neurologic symptoms,
> > confusional states,
> > weakness, and worsening heart failure are common clinical
> > presentations
> > of an acute infarction in elderly patients. Silent (unrecognized)
> > myocardial infarctions are common in the elderly and carry serious
> > prognostic implications."
>
> Am I right in inferring from this that you do a lot of 12 leads in
patients
> without chest pain? I thought the original purpose of the ambulance 12
lead
> was to identify patients for thrombolysis, so was relevant only in those
> with chest pain ongoing or over 30 minutes duration; and under 12 hours
> since onset. Are you doing fairly routine 12 leads now? I'm not saying
it's
> not a good idea especially if it doesn't delay transport; just that I
didn't
> think it was in most peoples protocols. (Just a thought: are you doing the
> 'pre-op' ECGs on patients with #NOF?)
>
> Matt Dunn
>
>
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