The Living Guidelines: UA/NSTEMI Recommendations for Initial Evaluation, Clinical Assessment and Management Polling Results for CLASS IIa Guidelines

Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the disclaimers page for important information regarding limitations of the information found here. In suggesting edits to the guidelines, WikiDoc suggests that the following classification scheme be used. Read more about the classification scheme used by the ACC / AHA Guidelines Committee here.

Class IIa Guidelines
1. It is reasonable for health care providers and 9-1-1 dispatchers to advise patients without a history of ASA allergy who have symptoms of ACS to chew ASA (162 to 325 mg) while awaiting arrival of pre hospital EMS providers. Although some trials have used enteric coated ASA for initial dosing, more rapid buccal absorption occurs with non enteric coated formulations. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1 for Initial Evaluation, Clinical Assessment and Management should be: CLASS I CLASS IIa CLASS IIb CLASS III 2. It is reasonable for health care providers and 911 dispatchers to advice patients who tolerate NTG to repeat NTG every 5 min for a maximum of 3 doses while awaiting ambulance arrival. (Level of Evidence: C)

 UA/NSTEMI Guidelines Class IIa Recommendation 2 for Initial Evaluation, Clinical Assessment and Management should be: CLASS I CLASS IIa CLASS IIb CLASS III 3. It is reasonable that all pre hospital EMS providers perform and evaluate 12-lead ECGs in the field (if available) on chest pain patients suspected of ACS to assist in triage decisions. Electrocardiographs with validated computer-generated interpretation algorithms are recommended for this purpose. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 3 for Initial Evaluation, Clinical Assessment and Management should be: CLASS I CLASS IIa CLASS IIb CLASS III 4. If the 12-lead ECG shows evidence of acute injury or ischemia, it is reasonable that pre hospital ACLS providers relay the ECG to a predetermined medical control facility and/or receiving hospital. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 4 for Initial Evaluation, Clinical Assessment and Management should be: CLASS I CLASS IIa CLASS IIb CLASS III