American college of cardiology /American heart association guidelines for st-elevation myocardial infarction-overview of guidelines for care before, during, and after STEMI

ST-elevation myocardial infarction (STEMI) is one of the leading causes of mortality in hospitals today and, thus, it is vital that evidence based guidelines for STEMI management are continually revised and that healthcare workers are made aware of new changes. STEMI management begins with prevention and patient education and extends through the event itself and secondary prevention. Each step in the response to STEMI is equally important and contributes to reduction of resulting morbidity and mortality. Those involved in this response include the patient, the patient's family, emergency medical service, and physicians, among others. The multifaceted nature of the response to STEMI requires that there is proper response at each step in the process to ensure the most appropriate STEMI management. Additionally, initial steps involving patient and community response require proper counseling to see to it that initial response is appropriate. In this chapter we outline the current STEMI guidelines for primary prevention, patient recognition, community response, emergency medical system response, emergency department response, revascularization, and in-hospital treatment. We address responsibilities of bystanders to physicians in STEMI response, highlighting the importance of proper communication and understanding between various stages of response to minimize response times and inefficiency.