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Checklist For Fibrinolytic Therapy

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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

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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