Acute Coronary Care

When a patient develops symptoms suggestive of and infarction, this section is emphasized. There acute coronary insufficiency, the health care sys are brief sections on prediction and prevention of tem is presented with a challenging diagnostic ischemic events, methods of diagnosing and siz and management problem. During the past 20 ing infarcts, and methods of monitoring the pa years, hospitals have been developing coronary tient with myocardial ischemia. A major focus of care units as the specialized inhospital facilities for the text is on "coronary care." As indicated above, such patients. For the past 15 years, many com during the past 20 years five distinct phases of munities have employed paramedical personnel coronary care have evolved: (a) prehospital, (b) to extend the principles of "coronary care" to the postadmission, (c) coronary care unit, (d) predis site of the patient who develops the problem. charge, and (e) convalescent. Cardiac rehabilitation programs have also been The section on pathophysiology begins with a established to facilitate the return to function of chapter by Greenfield and Rembert discussing patients who have had acute coronary insuffi the factors that determine the transmural distri ciency. More recently, aggressive medical and bution of blood flow. Reimer then shows the surgical techniques have been developed to either relationship between coronary blood flow and prevent or limit the extent of myocardial necrosis both reversible and irreversible damage to the that develops due to acute coronary insufficiency. myocardium.

The new edition continues to be a practical, easy to understand, and up to date resource for managing coronary disease. It not only encompasses modern cardiology practice, but also considers how the patient came to arrive on coronary care, and what will happen them after they leave. The combined authorship of doctor and nurse reflects the close teamwork vital to the management of both patients and their families. Management of the cardiac patent is a complex process and this book has a clear approach conveying the necessary information in an easily understood way. It also has an excellent evidence base to ensure best practice and should appeal to staff in every cardiac unit. Up to date coverage of a rapidly developing field Offers a multi-disciplinary approach to coronary care Easy to read and therefore easily understood Research/evidence based content ensures best practice Adds material that reflects the growing literature on nurse-lead approaches to chest pain assessment, defibrillation, thrombolysis and specialist clinics (heart failure and dysrhythmias). Updates content in line with the latest guidelines from various medical bodies.

A comprehensive coronary care textbook for medical, nursing and paramedic staff The Coronary Care Manual, 2nd Edition is a practical medical manual designed to assist with management of the acute coronary patient. This respected medical resource is written by a group of coronary experts, both Australian and international. Its aim is to strike a balance between a large and rapidly-changing evidence base and practical application in the Coronary Care Unit, Intensive Care Unit, Emergency Department and the ambulance. The second edition of this important health textbook covers an extensive range of coronary care medicine, providing a handy companion for a night 'on call'. Chapter topics in the Coronary Care Manual, 2nd Edition include pathophysiology, drug and non-drug therapies and postcoronary management, with chapters organised into subsections. Completely redesigned with fresh, new artwork, this new edition of the Coronary Care Manual is organised to suit academics and medical practitioners alike.

During the 25 years since acute coronary care was focused into Coronary Care Units there have been three major Phases: I. prevention of death caused by arrhythmias; II. prevention of death due to myocardial failure; and III. limitation of infarct size. In the latter two Phases, there has been infringement upon the time honored concept of a prolonged period of rest for the patient in general and the heart in particular to minimize myocardial metabolic demands. During the second Phase of coronary care, patients with myocardial failure received aggressive measures to increase cardiac work via increase in preload, decrease in afterload, and direct increase in inotropy. It was believed that true cardiogenic shock was so irreversible that it should be prevented by vigorous efforts to improve the cardiac output despite the risk of extending the area of ischemic myocardium. However, Phase II produced minimal overall reduction in mortality. In the initial part of Phase III, myocardial infarct (MI) size limitation was attempted by reducing myocardial metabolic demands via either beta adrenergic or calcium channel blocking agents. We are currently several years into the second part of Phase III of coronary care where the principle means of limiting MI size is restoration of coronary blood flow.

Acute Cardiac Care provides nurses with a comprehensive understanding of the current practice and principles underlying the care and management of acute cardiac conditions. It addresses the management of acute coronary syndromes (ACS) with an emphasis on evidence-based pharmacological management, cardiac emergencies (cardiac arrest, arrhythmia, acute pulmonary oedema, cardiogenic shock), current diagnostic and interventional modalities for the management of ACS, including risk stratification, and the ethical, political, social and economic factors that impact upon the provision of acute cardiac services in Australia and the UK. Edited by renowned academics and clinicians in the field, this practical text will encourage nurses to think critically about evidence and management of acute coronary conditions, and provide a guide on how and where to look for up-to-date evidence and guidelines. KEY FEATURES: A comprehensive and practical guide to the current practice and principles underlying the nursing care of acute cardiac conditions Edited by leading authorities in the field with a wealth of experience in acute cardiac care and resuscitation Has an emphasis on evidence-based practice, encouraging nurses to critically think about their practice Contains learning objectives, key points and activities and further reading guidelines

The concepts of acute coronary care are changing so rapidly that it is appropriate that the volume ACUTE CORONARY CARE: PRINCIPLES AND PRACTICE, published early in 1985, would have yearly updates. The process of rapid production of camera-ready manuscripts has added new capability to the exchange of information. ACUTE CORONARY CARE 1986 is the first of a series of yearly updates in this important area of cardiology. Materials published during the fall of 1984, including abstracts for the November American Heart Association meetings were reviewed by the editors to identify the areas of new information and the authors making important contri butions. Manuscripts were completed and edited during the spring of 1985 and the final camera-ready versions were delivered to Martinus Nijhoff by mid-July. The broad area of coronary care is divided into its five time sectors: Pre-hospital, Post-admission, Coronary Care Unit, Pre-discharge, and Conva lescent. As patients are more frequently encountered in the pre-hospital phase, it has become evident that alterations in the autonomic nervous system have a great impact on the clinical situation. The chapter by Ron Victor emphasizes the important interactions between the nervous system and the cardiovascular system in this critical situation.

Acute Coronary Syndrome: Urgent and Follow-up Care is a must-read for all those involved in the care of ACS, including EMS, nurses, advanced practice providers as well as physicians. This book not only reviews the causes of ACS, but also provides evidence-based acute and follow-up treatment recommendations that incorporate the perspectives of all those involved in the care of these patients. Epidemiology, pathophysiology, and outcomes of acute coronary syndromesThe role of EMS in the triage of the ACS patientEvaluation and treatment of the ACS patient in the emergency departmentPharmacologic management of the ACS patientFollow-up care of the ACS patientThe role of the team in carrying out successful guideline-driven care