Advanced clinical insights & practice: acute coronary syndrome.

This article provides the critical care paramedic with a review of the ongoing management of a patient with an acute coronary syndrome (ACS). In the March issue, we focused on the management and critical care transport of an unstable ACS patient from a small outlying community hospital back to the cath lab. In this article, we focus on the same patient as she progresses through the catheterization lab with complications. It is important to remember that, due to the instability of the precipitating condition, not all patients have a successful outcome with catheterization, and the critical care transport crew may be summoned again for transport.

Advanced clinical insights & practice: ischemic heart disease.

This issue sees the debut of a new series of continuing education articles. The series, Advanced Clinical Insights & Practice, is designed to provide continuing education to an ever-expanding realm of paramedicine that needs more of it: the critical care transport paramedic. Secondly, and equally important, are the benefits that can be reaped by other certification levels reading this feature. For EMT-Basics and Intermediates, it will provide a great enhancement to your core knowledge, although most of the interventions discussed will be beyond your traditional scope. For paramedics, it will augment both your pathophysiological understanding and clinical assessment/management skills of diseases and injuries discussed. Ultimately though, it is hoped that anyone who reads these articles will become a better clinician. The next article will appear in the July issue.