Short Description

This algorithm outlines the steps guiding the provider to efficiently assess and manage a patient with acute coronary syndromes (ACS).

Goals for the Management of ACS Patients

The provider must fulfill the following goals to successfully manage ACS patients:

• Recognize possible ACS and intervene with CPR and defibrillation as necessary.
• Identify STEMI and triage for early reperfusion therapy. 
• Relieve ischemic chest discomfort. 
• Prevent major adverse cardiac events. 
• Treat acute, life-threatening complications of ACS (VF/VT, symptomatic bradycardia, and unstable tachycardia).

Algorithm at a Glance

• The provider recognizes and intervenes in ACS using CPR, medications, and defibrillation, as necessary.
• The identification of ischemia is made early in the process.
• EMS and prehospital providers are essential to stabilize and transport the ACS patient to definitive care.
• In the emergency department, the type of MI is identified as STEMI, NSTE-ACS, or low-risk ACS so that STEMI can be treated with fibrinolytic or PCI therapy.
• The goal is to provide reperfusion therapy within 12 hours of symptom onset.