Nursing Management for Patients with ST-Elevated Myocardial Infarction at Emergency Department

Abstract

Incidence of acute myocardial infarction (AMI) has been increasing continuously. Worldwide, mortality rate attributable to AMI is approximately 2 deaths every hour. Among all types of acute coronary syndrome, ST-elevated myocardial infarction was diagnosed as high as 40 percentage. The purpose of this integrative literature review aimed to identify existing factors in nursing management that delay time to myocardial reperfusion at emergency department, and to provide strategies to reduce the delay in the context of emergency department at the secondary-level hospital. This review was based on studies extracted from electronic databases, including PubMed, THAIJO, ProQuest, and ScienceDirect between 2012 and 2022. Ten articles with full-text published in English and Thai met the inclusion criteria. Total articles were then selected based on the quality of Joanna Briggs Institute critical appraisal. The result of this integrative literature review showed that the problems of nursing management for patients with ST-elevated myocardial infarction at emergency department included: (1) delayed to perform EKG, (2) delayed to interpreted EKG, and (3) delayed to prepare treatment team. The major goal of AMI management is to provide early myocardial reperfusion either by thrombolytic therapy or coronary intervention. Consequently, quick review of patient symptoms and necessary clinical investigations as well as appropriate management in a timely manner may reduce mortality risk from life-threatening complications. Emergency department is the most common point of medical contact where patients seek care for AMI. Therefore, fast and effective nursing management is imperative.