Cardiogenicadvanced8 min
Inferior infarct, a drowning RA
Handover
Inferior STEMI, atropine already given, lungs clear, JVP to the ear. RA 18, PCWP 10, PA 28/16, PAPi 0.67, HR 58. The RV took the infarct. A little fluid, then an inotrope. The nitroglycerin in the STEMI bundle is how you make this worse. Severe TR is lying about the thermodilution CO.
Untreated tamponade, massive PE, or a crashed CPO/PAPi will keep dropping MAP and climbing lactate. Name the tracing, then move.
Goals
- · Inotrope for the RV
- · MAP ≥ 68
- · Careful volume given