Tag: lbbb

Myocardial Infarction (MI) – PPCI/Thrombolysis

PPCI (Leeds PPCI Pathway)

  • Target: Door to balloon 90min
  • Criteria:
    • Time: Chest pain within 12hrs (or worsened within 12hrs)
    • ECG:  ST elevation MI (1mm Limb or 2mm Chest leads) OR New LBBB. (Posterior MI do posterior leads and discuss with LGI)
  • Actions:
    • Resuscitate
    • Contact PPCI team @ LGI (Mobile No. up in Resus)
    • Arrange blue light (P1) ambulance to LGI
    • Prasagrel 60mg if no previous CVA or Ticagrelor 180mg if previous CVA and Aspirin 300mg (if anti-coagulated Discuss with PCI team)
  • Problems: 
    • Intubated patient: Often LGI would accept but need to arrange Cardiac ICU. If no bed patient could go for PCI to return locally immediately after PCI to our ICU’S?
    • LGI Full: Occasionally the cath lab is full and can’t accept your patient
      • Calling Manchester and Sheffield: It’s worth a go but they don’t have agreements with us  so having your patient accepted can be difficult
      • Don’t Forget Thrombolyisis: We need to open up the patients artery, if there is no quick decision to go for PPCI – Consider Thrombolysis

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