Cardiac Thrombosis​

• Refers to a blockage of a coronary artery (or arteries) by a blood clot.​
• This blockage leads to heart muscle damage (Acute MI), which can result in lethal arrhythmias and/or a decreased cardiac output causing cardiac arrest

Why Leave Early?​

• Time is heart muscle. The quicker that the thrombosis is treated, the better the chance of survival​
  • Thrombosis can be treated in-hospital via:​
    • Thrombolytic (TNK)​
    • PCI at cath lab facilities*

*Each cath lab has its own dynamic capabilities and may or may not be able to accept a patient in cardiac arrest. Follow the STEMI Bypass Guidelines and local service-hospital policies.​

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When to Leave Early?​

• The thrombosis causing arrest that we are searching for is STEMI​
  • Requires clinical symptoms consistent with cardiac ischmia​
  • Requires a STEMI ECG PRIOR to cardiac arrest
• Why do we need to see STEMI prior to arrest?​
  • Ischemia from cardiac arrest can cause STEMI due to the ischemic injury from lack of sufficient bloodflow​
    • We want to ensure we are stopping our resuscitation to transport a patient early ONLY IF the cause is a blockage of the coronary arteries (prehospital prearrest STEMI tells us about concern for blockage)​

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In Summary

• Cardiac thrombosis refers to a blood clot blocking coronary arteries – causing MI. This is detected in the prehospital realm by pre-arrest STEMI positive ECG​
• Consider very early transport for patients with a STEMI positive 12-Lead ECG (along with clinical symptoms of MI) prior to cardiac arrest​
  • Otherwise, treat per the Medical Cardiac Arrest medical directive 

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