การพยาบาลผู้ป่วยกล้ามเนื้อหัวใจตายเฉียบพลันชนิดเอสทียกสูง: กรณีศึกษา

Abstract

ST-elevation myocardial infarction. It is a crisis causing a high death rate. If there is a delay in diagnosis and treatment. Therefore, emergency department nurses must have the ability to assess, screen, read and interpret EKG. Provide care and monitoring for complications from the moment the patient arrives at the hospital. coordinate treatment with doctors, give the patient rapid fibrinolytic agent, or refer to perform a cardiac catheterization and can safely expand the coronary arteries. The purpose of this study is to present case studies of 2 patients who were diagnosis with acute myocardial infarction with ST elevation as follows:
Case study 1: A 70-year-old male patient with no underlying disease presented with symptoms of dizziness, and tightness in the middle of the chest. 2 hours before coming to the hospital, received EKG 12 lead Show ST elevation at Lead 2, 3, AVF BP 89/50 mmHg received NSS iv Load 200 cc, Dopa 200mg+5%D/W 100 ml iv drip 5ud/ min, doctor diagnosis STEMI Inferior wall received ASA Gr V 1 tab, Plavix 4 tabs, consult cardiologist, transfer and coordinate the fast track for CAG and PCI. During the referral there was Cardiac arrest, EKG Show VF, 4 minutes of CPR and 1 time of Defibrillation. There was ROSC, GCS E4V5M6, received referral for CAG and PCI according to the treatment plan.
Case study 2, A 73-year-old female patient presented with dizziness and chest tightness 1 hour before coming to the hospital, received EKG12 lead, ST elevate in V3 not thinking of STEMI, received Losec 40 mg vein, Dimen 1 amp vein and Send lap Trop-T and observe symptom. The chest pain did not improve. A 12 lead EKG was repeated and ST elevation V3-V6 and Trop-t High Risk results were found. consult a cardiologist. The doctor diagnosis STEMI anterior wall and gives ASA Gr V 1 tab, Plavix 4 tabs, Streptokinase 1.5 mu vein drip in 1 hr. The angina pain subsides. Refer to CAG and pharmaco invasive PCI accordingly. Treatment plan
The results of the study found that, both case studies were cases of elevated ST myocardial infarction. Receive care and referral according to the doctor's treatment plan. Provide nursing care using the nursing process according to the patient's symptoms. Patients are safe and out of crisis. can go home, There were no complications and continued care was received at the community hospital