Acute myocardial infarction- what hospital is appropriate & the use of Ondansetron use in the setting of an Acute myocardial infarctio
Identify the type of receiving medical facility that is an appropriate destination for the patient with consideration to their presenting condition. Justify why based upon the potential immediate and ongoing management requirements of the patient. (Hospital containing a Cath Lab)
Critically investigate and discuss the introduction of the use use of oral Ondansetron in the setting of an Acute myocardial infarction
Ensure that the potential positive and negative aspects of the intervention with relation to patient outcome(s) specfic to an an Acute myocardial infarction.
No into or conclusion nessessery
What Hospital is Appropriate & the Use of Ondansetron in the Setting of an Acute Myocardial Infarction
Medical facilities that act as receiving centers for patients with acute myocardial infarction must have accredited that is provided by the American Heart Association in partnership with the Society for Cardiovascular Patients Care. According to these organizations, a hospital or medical facility that acts as an ST-elevation myocardial infarction (STEMI) receiving center should meet certain standards and criteria (Time, 2015). Particularly, the most appropriate ST-elevation myocardial infarction (STEMI) receiving center should have adequate staffs that have the necessary expertise besides having facilities and equipment that are capable of performing percutaneous coronary intervention (PCI) efficiently. Moreover, they should be able to perform percutaneous coronary intervention (PCI) on a 24-hour basis without interruption so as to help in improving blood flow in patients. This minimizes chest pains that are related to this condition and increase the ability of patients to be active (Ibrahim, Riddell & Devireddy, 2014). Appropriate procedures and standing orders too should be enhanced to help in easy identification of STEMI. These procedures and protocols should be available in the Intensive care units or coronary care units and at the departments dealing with emergencies.
Appropriate acute myocardial infarction receiving center should have cardiac catheterization hubs that are capable of offering interventional cardiology facilities. The Cath labs should be fitted with modern digital cardiac and vascular imaging systems which provide a diagnosis and treatment plan for these patients. The Cath labs should be used for both emergency and scheduled heart procedures to ensure a rapid diagnosis and treatment of acute myocardial infarction conditions (Cahill et al., 2015). In this way, these receiving hospital centers will be able to improve and save a life within the minimum time possible through identification and treatment of heat-related diseases.
An appropriate receiving medical facility should always operate in coordination with the emergency medical services (EMS) and non- PCI centers for the referral so that they can always be prepared for emergency treatment when STEMI are brought in. Since acute myocardial infarction is a far-reaching condition, these facilities should be ready to treat patients with this condition as soon as they arrive at the facility. An appropriate receiving hospital should facilitate faster and emergency transportation of STEMI patients whenever there is an emergency or when there is a patient requiring immediate attention, no matter their location. Such facilities should ensure that patients arrive at the hospital premises within the shortest time possible.
The right receiving centers should always ensure that they participate in a multidisciplinary team consisting of representatives from EMS, emergency services, quality improvement, coronary care unit, nursing staff, Cardiac Catheterization laboratory and physician staff. The STEMI hospital facilities should hold regular meeting with these groups so as to identify and discuss solutions to problems and also to make consistent cardiac care improvements. Also, hospitals that act as STEMI Receiving Centers should be supported by tools, resources, and equipment and have representatives who are capable of answering all questions along the way. The receiving facilities should also engage in extensive data collection, research, and performance evaluation to continually improve on their services.
In most occasions, acute myocardial infarction may be accompanied by nausea and vomiting. Patients often experience joint pain beneath the sternum. Acute myocardial infarction patients also experience chest pains that are related to their heart condition. During and after surgery, the intensity of these shocks may increase making the patient uncomfortable. Some patients may also give a history of angina pectoris. Oral administration Ondansetron is used to keep these pains and symptoms to a minimum. Ondansetron helps by blocking the activity of serotonin which is a natural substance that can result in nausea and vomit (Hartley, Kuhn, Valley, et al. S2013)
Although oral administration of Ondansetron is very useful in reducing vomiting nausea and chest pains experienced by patients with acute myocardial infarction, it has some limitations. Notably, Ondansetron cannot be administered to patients whose relative has a history of sudden cardiac death when they were below 50 years old. Administration of this medicine can result in an increase in an irregular heartbeat with prolonged QT intervals (Freedman, Uleryk, Rumantir, et al. 2014). Oral administration of Ondansetron may also slow or increase a patient’s pulse rate thereby putting them at a higher risk than when it is not administered. Before the oral administration of Ondansetron, patients may be required to undergo an electrocardiogram (ECG), which is yet another strenuous medical process undergone by the patients. Besides, administration of this medicine to a patient with STEMI conditions may cause other serious problems like temporary blindness, fatigue, dizziness and may even make a patient go into a coma. It may also cause other mild effects such as confusion, hallucinations, seizures excessive sweating and fever.
Cahill, T. J., Clarke, S. C., Simpson, I. A., & Stables, R. H. (2015) A patient safety checklist for the cardiac catheterisation laboratory Heart, 101(2), 91-93.
Freedman, S. B., Uleryk, E., Rumantir, M., & Finkelstein, Y. (2014) Ondansetron and the risk of cardiac arrhythmias: a systematic review and postmarketing analysis. Annals of emergency medicine, 64(1), 19-25.
Hartley, S., Kuhn, L., Valley, S., Fallouh, N., Dussán, K. B., Judd, S., … & Chopra, V. (2013). Off-label use of Ondansetron in hospitalized medical patients: prevalence, patterns, and predictors. JCOM, 20(9).
Ibrahim, A. W., Riddell, T. C., & Devireddy, C. M. (2014).Acute myocardial infarction Critical care clinics, 30(3), 341-364.
Kristensen, S. D., Laut, K. G., Fajadet, J., Kaifoszova, Z., Kala, P., Di Mario, C., … & Alhabib, K. F. (2014). Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries. European heart journal, eht529.
Squire, B. T., Tamayo-Sarver, J. H., Rashi, P., Koenig, W., & Niemann, J. T. (2014) Effect of prehospital cardiac catheterization lab activation on door-to-balloon time, mortality, and false-positive activation Prehospital Emergency Care, 18(1), 1-8
Steg, P. G., James, S. K., Atar, D., Badano, L. P., Lundqvist, C. B., Borger, M. A., … & Gershlick, A. H. (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation European heart journal, ehs215.
Time, W. E. O. (2015) Acute myocardial infarction JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 65(2)