Nitrates in ACS.

[Smash]

Here's a quick nice review from a gent in NM.
RM

I presume that was aimed at a BLS level, however there are quite a few things that aren't really that flash in this presentation.

The discussion on O2 seems to focus on the patient who is ventilated (may cause lung damage at high pressure, may cause ventilator dependency) ignoring the potential harm that comes from O2 given to ACS patients and the lack of rationale for it's use.

The bizarre insistence on increasing preload in RVI infarcts with fluids (a good idea), only to reduce it with nitrates (a very bad idea) gets trotted out again. Strangely it seems that reducing preload with beta-blockers is bad, but reducing it with nitrates is good. Odd.

I did enjoy the slides that state that the beneficial effects of morphine/fentanyl is pain relief, but the downside is... pain relief (and of course QTc elongation - I presume they mean prolongation) and I had to laugh out loud at plavix being "well tested" with a "well established patient safety profile"!

The author should probably also review the actions of heparin.

 

[RealMedic]

Reply to Smash on ACS/Nitrates post

Hi Smash, Yeah well the title "quick review" was a dead give away for it not going into great detail for ya. Glad you enjoyed it though and your opinions and thoughts relating to the presentation/material are interesting as well.
Be safe friend!
RM