Effective Communication And Time Management For A Patient...

Adult Case study – Effective communication and time management for a patient with an Acute ST-elevated Myocardial Infarction. Case study The NMC code of conduct states â€Å"As a nurse or a midwife, you owe a duty of confidentiality to all those who are receiving care† (NMC; 2015 p.5). In accordance with the NMC code of conduct I shall be using a pseudonym to discuss my patient. Mr Alpha is a 55 year old paramedic who started complaining of chest pain, nausea and shortness of breath at 08:00 which improved with Paracetamol and Aspirin. Whilst at the Royal London hospital his colleague conducted an ECG at approximately 11:45 which showed ST-elevation in leads V3 and V4 and was brought into the Emergency Department (ED) as an ST-Elevated†¦show more content†¦Introduction A STEMI is caused by an acute interruption of blood supply to an area of the heart that develops into full thickness cardiac muscle damage to the area that the vessel supplies blood to (Wadud, A; 2014). It is defined by having ST-segment elevation with pathological Q-wave formation and is condition under the umbrella term Acute Coronary Syndrome (ACS) (Wadud, A; 2014). The lack of oxygenation to the myocardium also causes the cardiac markers troponin T, troponin I and creatinine kinase myocardial brand (CK-MB) start to rise in the blood. Troponin rises within 4-6 hours and remains raised for up to two weeks whilst CK-MB starts to rise within 4-6 hours and returns to normal within 48-72 hours (Wadud, A; 2014). Nice guidance identifies that â€Å"nearly half of potentially salvageable myocardium is lost within 1 hour of the coronary artery being occluded and two thirds are lost within 3 hours† (NICE; 2013). The end of the 20th century showed the best way to re-perfuse and improv e oxygenation was using a fibrinolytic drug however in recent years the use of Coronary Angioplasty, thrombus extraction catheters and stenting which are under the umbrella term Percutaneous Coronary Intervention (primary PCI) (NICE; 2013). The National Infarct Angioplasty Project (NIAP) interim report found that primary PCI will be feasible in a variety of geographical settings, will be most effective and cost-effective if delivered within 120-150 minutes from a patient’s initial call for