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Checklist For Fibrinolytic Therapy

ACLS
certification institute
www.aclscertification.com
1 Patient has complaints consistent with Acute Coronary Syndrome
for greater than 15 min and less than 12 hrs?

2 Does 12-Lead ECG reflect STEMI


No Yes or
presumably new LBBB?

No Yes

3 Assess for any contraindications to fibrinolytic therapy:


(Fibrinolytic therapy may be contraindicated if any of the following are marked YES)

Systolic BP >180-200 mm Hg or diastolic BP >100-110 mm Hg? Yes No


Systolic BP in left vs right arm differs by >15 mm Hg? Yes No
Patient history of structural central nervous system disease? Yes No
Significant closed head/facial trauma within previous 3 weeks? Yes No
Stroke >3 hours or <3 months? Yes No
Any major trauma, surgery (including laser eye surgery),
GI/GU bleed, within 4 weeks? Yes No
Any history of intracranial hemorrhage? Yes No
History of bleeding/clotting problems, or patient is taking
blood thinners? Yes No
Patient is currently pregnant? Yes No
Advanced cancer or severe liver, kidney, or other serious systemic
disease? Yes No

4
Is patient at high risk?
(Consider transfer to PCI facility if ANY of the following are checked YES)

_
Heart rate >100 AND systolic BP <100 mm Hg? Yes No
Signs/symptoms of pulmonary edema? Yes No
Patient shows signs of shock? Yes No
Contraindications to fibrinolytic therapy? Yes No

5 If contraindications to fibrinolytic therapy,


consider transporting patient to cardiac cath lab
for PCI therapy

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