Subject(s)
Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/nursing , Nurse's Role , Acute Coronary Syndrome/therapy , Diagnosis, Differential , Electrocardiography , Emergency Medical Services/methods , Humans , Myocardial Reperfusion/methods , Myocardial Reperfusion/nursing , Pain Measurement , Practice Guidelines as TopicABSTRACT
As técnicas de imagens funcionais da medicina nuclear nunca apresentaram uso tão amplo e difundido como o que ocorreu na última década. Isso se deve principalmente ao fato de que agora a comunidade médica mundial entende mais claramente que há limitações nas imagens clínicas baseadas exclusivamente em anatomia e percebe mais claramente a necessidade de complementarem as informações morfológicas e funcionais com as chamadas "imagens moleculares". A capacidade desse tipo de estudo vem avaliar a perfusão miocárdica de acordo com o território de irrigação coronária proporciona grande auxílio na investigação da doença arterial coronária, bem como na definição de condutas clínicas e acompanhamento do paciente. Neste artigo serão discutidas algumas das principais aplicações clínicas da cintilografia de perfusão miocárdica: diagnóstico de doença arterial coronária; avaliação prognóstica e estratificação de risco; avaliação funcional de lesões anatômicas conhecidas; avaliação após...
Subject(s)
Humans , Aged , Coronary Disease/diagnosis , Myocardial Revascularization/methods , Acute Coronary Syndrome/diagnosis , Electrocardiography , Risk Factors , Nuclear Medicine , Radioisotopes , Myocardial Reperfusion/nursingABSTRACT
In this article Nick Castle explains that, with significant improvements being made to the emergency management of cardiac patients, emergency nurses should challenge and develop their clinical practice to ensure patients receive prompt and evidence based treatment.
Subject(s)
Emergency Nursing/methods , Myocardial Infarction/nursing , Myocardial Reperfusion/methods , Myocardial Reperfusion/nursing , Emergency Medical Services/organization & administration , Fibrinolytic Agents/therapeutic use , Humans , Models, Nursing , Myocardial Infarction/diagnosis , Myocardial Infarction/drug therapy , Myocardial Reperfusion/standards , Myocardial Reperfusion/statistics & numerical data , Nurse's Role , Outcome and Process Assessment, Health Care , Practice Guidelines as Topic , Recombinant Proteins/therapeutic use , Streptokinase/therapeutic use , Tenecteplase , Thrombolytic Therapy/methods , Thrombolytic Therapy/nursing , Thrombolytic Therapy/standards , Thrombolytic Therapy/statistics & numerical data , Tissue Plasminogen Activator/therapeutic use , United KingdomABSTRACT
Desde la década de los ochenta, el tratamiento trombolítico en el infarto agudo de miocardio (IAM) se ha confirmado como una de las alternativas terapéuticas para la reperfusión precoz del miocardio en la fase aguda de esta enfermedad. A pesar del claro beneficio del tratamiento trombolítico, nos podemos encontrar con un 30-40 por ciento de pacientes con ausencia de restablecimiento del flujo coronario en la zona afectada, lo que da lugar a un deterioro clínico y hemodinámico rápido e importante que precisa la realización de una angioplastia coronaria transluminal percutánea (ACTP) de rescate. El objetivo del trabajo fue valorar y detectar, tras la instauración del tratamiento fibrinolítico, el fracaso de éste mediante la monitorización por parte de enfermería de los indicadores de no reperfusión: el dolor y las alteraciones electrocardiográficas relacionados con el comportamiento del segmento ST y las arritmias. Los resultados obtenidos demostraron que la monitorización del segmento ST del electrocardiograma fue el mejor indicador de no reperfusión en pacientes diagnosticados de IAM con tratamientos fibrinolíticos (AU)
Subject(s)
Adult , Female , Male , Middle Aged , Humans , Angioplasty, Balloon, Coronary/methods , Critical Care/methods , Thrombolytic Therapy/methods , Angioplasty, Balloon, Coronary , Myocardial Infarction/surgery , Myocardial Infarction/drug therapy , Thrombolytic Therapy/nursing , Treatment Outcome , Myocardial Reperfusion/nursing , Electrocardiography/methodsSubject(s)
Electrocardiography, Ambulatory/methods , Monitoring, Physiologic/methods , Myocardial Infarction/diagnosis , Algorithms , Coronary Angiography , Coronary Vessels/physiopathology , Critical Care/methods , Decision Trees , Drug Monitoring/methods , Electrocardiography, Ambulatory/nursing , Humans , Monitoring, Physiologic/nursing , Myocardial Infarction/mortality , Myocardial Infarction/physiopathology , Myocardial Infarction/therapy , Myocardial Reperfusion/methods , Myocardial Reperfusion/nursing , Nurse's Role , Predictive Value of Tests , Thrombolytic Therapy , Treatment Outcome , Vascular PatencySubject(s)
Myocardial Infarction/therapy , Myocardial Reperfusion/methods , Myocardial Reperfusion/trends , Thrombolytic Therapy/methods , Thrombolytic Therapy/trends , Algorithms , Critical Care/methods , Critical Pathways/organization & administration , Decision Trees , Humans , Myocardial Reperfusion/nursing , Patient Care Team/organization & administration , Thrombolytic Therapy/nursingABSTRACT
Thrombolytic therapy is rapidly becoming the standard of care for the treatment of acute myocardial infarction (AMI). The goal of thrombolytic therapy is clot dissolution in the infarct artery that results in re-establishing blood flow to affected ischemic myocardium. Confirmation of the occurrence of reperfusion can only be established by direct visualization of the coronary artery. Clinical reperfusion markers (dysrhythmias, chest pain relief, ST segment normalization, CK peak values) have also been associated with myocardial reperfusion. These markers are noninvasive and are routinely relied on in the clinical setting. However, a review of the literature reveals that the noninvasive reperfusion markers individually lack reliability in successfully predicting reperfusion status. Because of the importance of establishing the success of reperfusion therapy early in the treatment of AMI, it is critical that the nurse at the bedside be aware of the criteria that can be established to improve the reliability of the reperfusion markers and their limitations.
Subject(s)
Myocardial Infarction/therapy , Myocardial Reperfusion/nursing , Nursing Assessment , Critical Care , Humans , Myocardial Reperfusion/methods , Thrombolytic TherapyABSTRACT
Recognition of the clinical markers of reperfusion and comprehension of the effects of reperfusion injury in acute myocardial infarction provide a unique challenge for today's critical care nurse. In this article we will explore the processes of reperfusion injury. A review of relevant literature and presentation of a clinical case study and care plan will enable the critical care nurse to construct a larger knowledge base and assist in the nursing management of patients with acute myocardial infarction. Evaluation and treatment of reperfusion and reperfusion injury remains under investigation, but through the skills of assessment, planning, and intervention the critical care nurse can coordinate prompt and appropriate care to the patient with an acute myocardial infarction.
