List actions for immediate management.
Perform a focused clinical evaluation and ABCDE survey.
Obtain 12-lead ECG within 10 minutes of patient arrival.
Measure cardiac troponin as soon as possible upon clinical presentation.
Initiate supplemental O2 for cyanosis, respiratory distress, or SpO2 < 90%.
Give aspirin if there are no contraindications.
Consider adjunct medical therapy for ACS, e.g., sublingual nitroglycerin for chest pain relief.
Describe the initial triage based on ECG findings.
ST elevations present: Start management of STEMI with immediate revascularization therapy, preferably PCI.
No ST elevations present
ST depressions, new T-wave inversions, and/or high clinical suspicion for ACS: Begin management of NSTEMI/UA.
ECG nondiagnostic AND low/intermediate clinical suspicion for ACS
Obtain serial ECGs and repeat troponin.
Consider further investigations based on risk stratification for ACS.