Physician's Orders

CPER TRACK I: ACUTE MI

1. Condition Guarded NOTIFY CCU RESIDENT
2. Bedrest
3. When a meal service is appropriate, give Soft Diet as tolerated
4. Rapid Assay Troponin-T
5. 12 Lead EKG on arrival. Maintain continuous recording in CPER.

1. Cardiac monitoring. Document rhythm Q 2 Hrs
2. Nasal O
3. V.S. Q 15 min. until 15 min after infusion of thrombolytic drug is completed, then Q1H x 2, then Q2H if stable. Record.
4. Tympanic temperature on admission, then Q4H. Record
5. Portable Chest X-ray STAT
6. Initiate I.V. Access with saline lock(s). Two separate sites are preferably: do not hold thrombolytic therapy if only one site can be accessed.
7. STAT CBC, SMA 12, U/A, PT, PTT, Thrombin time
8. Myoglobin at 0, 2, and 4 hours
9. CPK/MB at 0, 6, and 12 hours
10. SGOT, SGPT, LDH within 24 hours of arrival
11. Lipid Profile within 24 hours of arrival

CPER TRACK I: ACUTE M.I. - THROMBOLYTIC THERAPY

1. Check allergy to aspirin and record
2. If no known allergy to aspirin, give Baby Aspirin 160 mg P.O. Stat
3. then Aspirin 325 mg P.O. QD thereafter
4. Pull standing order sheets for : (PHYSICIAN: INITIAL INDICATED PROTOCOL)
   
   

1. Admit to CCU

CPER TRACK I: Acute MI
CPER TRACK II: Probable Unstable Angina or Non-Q Wave Infarction
CPER TRACK III: Suspected Ischemia
CPER TRACK IV: Uncertain Etiology
CPER TRACK V: Non-Cardiac Chest Pain

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