Date Published

February 12, 2020

Updated For

ALS PCS Version 5.2


Remember that a patient whose ST elevation is identified post-ROSC is NOT a STEMI Bypass candidate.

Resuscitation maneuvers including CPR and defibrillation can cause ST elevation on ECG and be a mimic, rather than an actual STEMI. The arrest may have been from another cause aside from STEMI and requires a full work-up. Diversion of care directly to the cath lab may hinder appropriate timely treatment in these patients.

However, a patient with cardiac ischemia chest pain and a 12-Lead ECG indicating STEMI, who subsequently goes into VF arrest, is shocked and has immediate ROSC AND is deemed to be STABLE, can be considered for STEMI Bypass. Go ahead and make the call in these patients, as the ischemia is likely what caused the arrest, and this can may be expediently treated in the cath lab.


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