Page 20 - JSOM Fall 2021
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In-Flight Considerations                           References
          1.  Maintain O  saturations > 90%.                  1.  Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep.
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          3.  In the event of an inflight STEMI (new vs. reinfarction),   3.  Shrestha A, Ho TE, Loryana L, et al. Comparison of cardiovas-
            thrombolytics should be given unless a contraindication   cular health between U.S. Army and civilians. J Am Heart As-
            exists (see Appendix A).                            soc. Originally published 5 Jun 2019.  https://doi.org/10.1161
          4.  If the patient becomes unstable in-flight, consideration   /JAHA.118.009056 Journal of the American Heart Association.
            of diversion to the closest location with PCI capabilities   2019;8:e009056
            should be strongly considered. An unstable patient is one   4.  2019 Health of the Force. 2019.  https://phc.amedd.army.mil
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               be controlled with ACLS medications (e.g., β-blockers,   6.  Webber BJ, Seguin PG, Burnett DG, et al. Prevalence of and risk
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                                                                members, 2001-2011. JAMA. 2012;308:2577–2583.
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            rival to a facility with these therapies available.  9.  Tintinalli JE, Ma OJ, Yealy DM, et al.  Tintinalli’s  emergency
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            transfer to a higher level of care.              10.  Walls RM, Hockberger RS, Gausche-Hill M. Rosen’s emergency
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          2.  All patients diagnosed with STEMI are transferred to a PCI   farction on the signal-averaged ECG. Results of a multicenter
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                                                             13.  O’Gara PT, Kushner FG, Ascheim DD, et al. The American
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            •  Theater MEDICAL DATA STORE                    17.  Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition
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          System Reporting and Frequency                     18.  Amsterdam EA, Wenger NK, Brindis RG, et al. The American
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          of  this  CPG.  System  reporting  frequency  will  be  performed   guideline for the management of patients with non-ST– elevation
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          be performed as needed.                            19.  Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition
                                                                of myocardial infarction (2018). Circulation. 2018;138:e618–e51.
          The system review and data analysis will be performed by the   20.  Demystifying the 12 lead ECG!  https://nurseyourownway.com
          JTS chief, program manager, and PI branch.            /2016/04/20/demystifying-the-12-lead-ecg/. Accessed July 2021.
                                                             21.  Anterior  myocardial  knfarction. 2019.  https://litfl.com/anterior
          Responsibilities                                      -myocardial-infarction-ecg-library/. Accessed May 2021.
          It is the chief of trauma’s or equivalent’s responsibility to en-  22.  Inferior STEMI. 2019. https://litfl.com/inferior-stemi-ecg-library/.
                                                                Accessed May 2021.
          sure familiarity, appropriate compliance, and PI monitoring at   23.  Lateral STEMI. 2019.  https://litfl.com/lateral-stemi-ecg-library/.
          the local level with this CPG.                        Accessed May 2021.


          18  |  JSOM   Volume 21, Edition 3 / Fall 2021
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