Collabrative Case Study
University of Phoenix
Theoretical Foundations of Professional Nursing
Kimberly Frommel, MSN, RN
Collaborative Case Study
This is a case study of the collaborative care that happens in order for the hospital to meet its STEMI (ST-Elevation Myocardial Infarction) guidelines. The STEMI guidelines are for STEMI patients to go from hospital door to dilation in less then 90 minutes. The dilation is the part of the cardiac catherization done in the cardiac catherization lab. This case study is going to show collaboration between emergency medical services paramedics and EMT's (Emergency Medical Technicians), the emergency room staff, the Cardiac Catherazation staff, the hospital laboratory staff, the hospital supervisor, pastoral care, physicians, patients family, and the patient. Background
A 47 year old Caucasian male starts experiencing chest pain, shortness of breath with diaphoreses after mowing his lawn. While resting the patient starts experiencing a headache and left arm pain, it is 6:45 pm on a Monday. His wife calls 911. The fire department is the first to respond with an EMT, they take his vital signs, place a non rebreather oxygen mask on him giving him 15 liters of oxygen. The ambulance arrives with a paramedic who connects the patient to a cardiac monitor which shows ST elevation. The patient is quickly given sublingual nitro and 3, 81 mg chewable aspirin, while the fire departments personnel are bringing the stretcher to the patient. Meantime a brief medical history report is being obtained from the family. The patient is loaded into the back of the ambulance and the family is giving information on where the patient is being taken. The Paramedic obtains IV access on the patient, gives the patient 4mg of morphine IV, IV fluids and an inch of nitro paste on his chest. He then performs a 12 lead EKG that shows ST elevation. . The ambulance driver radios their dispatch that they are responding code 3 to the...
References: Moscussi, M, & Eagle, K (2006). Reducing the Door-to-Ballon Time for Myocardial Infarction with ST-Segment elevation. New England Joural of Medicine. 355, 2364-2365.
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