Assess Applicability for Triage Post cardiac arrest with ROSC -OR- years of age with symptoms lasting more than 10 ≥21 minutes but less than 12 hours suspected to be caused by Transport per regional patient care procedures coronary artery disease: Chest discomfort (pressure, crushing pain, tightness, heaviness, cramping, burning, aching sensation), usually in the center of the chest lasting more than a few minutes, or that goes away and comes back. Pain or discomfort in 1 or both arms, neck, jaws, shoulders or back. Shortness of breath with or without chest discomfort. Epigastric (stomach) discomfort, such as Assess High Risk Criteria unexplained indigestion, belching, or pain. In addition to symptoms in Other symptoms may include sweating, nausea Box 1, vomiting, and lightheadedness. Pt. has 4 or more of the following: might not Note: diabetics, and geriatric patients Age 55 ≥ have chest discomfort or pain. Instead they might have If EMS personnel 3 or more CAD risk factors: nausea/vomiting, back or jaw pain, fatigue/weakness, or Still suspect an acute coronary family history generalized complaints. high pressure high cholesterol Yes If ALS has not been dispatched, diabetes upgrade if available. current smoker Aspirin use in last 7 days Assess Immediate Criteria anginal events in last 24 Yes Post cardiac arrest with return of spontaneous circulation NO ≥2 Hours, including current Hypotension or pulmonary episode EKG positive for STEMI (if available) Yes Known coronary disease NO ST deviation 0.5 (if ≥ available) Elevated cardiac markers . (if available) Assess Transport Time and Determine Destination by of Prehospital Care Level II Cardiac Hospital 60 BLS/ILS ALS Yes Minutes closer than Level I? Level II Cardiac Hospital 30 Minutes closer than Level I? Yes State of Washington Prehospital Stroke Triage Destination Procedure
Assess Applicability for Triage Post cardiac arrest with ROSC -OR- ≥21 years of age with symptoms lasting more than 10 minutes but less than 12 hours suspected to be caused by coronary artery disease: Chest discomfort (pressure, crushing pain, tightness, heaviness, cramping, burning, aching sensation), usually in the center of the chest lasting more than a few minutes, or that goes away and comes back. Pain or discomfort in 1 or both arms, neck, jaws, shoulders or back. Shortness of breath with or without chest discomfort. Epigastric (stomach) discomfort, such as unexplained indigestion, belching, or pain. Other symptoms may include sweating, nausea vomiting, and lightheadedness. Note: diabetics, and geriatric patients might not have chest discomfort or pain. Instead they might have nausea/vomiting, back or jaw pain, fatigue/weakness, or generalized complaints. Transport per regional patient care procedures Assess High Risk Criteria In addition to symptoms in Box 1, Pt. has 4 or more of the following: Age ≥ 55 3 or more CAD risk factors: family history high pressure high cholesterol diabetes current smoker Aspirin use in last 7 days ≥2 anginal events in last 24 Hours, including current episode Known coronary disease ST deviation ≥ 0.5 (if available) Elevated cardiac markers . (if available) NO If EMS personnel Still suspect an acute coronary Assess Immediate Criteria Post cardiac arrest with return of spontaneous circulation Hypotension or pulmonary EKG positive for STEMI (if available) NO Yes If ALS has not been dispatched, upgrade if available. Yes Yes Assess Transport Time and Determine Destination by of Prehospital Care BLS/ILS ALS Level II Cardiac Hospital 30 Minutes closer than Level I? Level II Cardiac Hospital 60 Minutes closer than Level I? Yes Yes State of Washington Prehospital Stroke Triage Destination Procedure