The challenge of myocardial infarction in accident and emergency nursing

This article reviews recent changes in the care of individuals who have suffered a Myocardial Infarction (MI). The realisation that infarction is a dynamic process which occurs rapidly has resulted in a greater emphasis being placed on the speed and efficacy of treatment. A brief outline of the disease process and predisposing risk factors is given. The use of several thrombolytic agents is examined, and a discussion of whether the benefits outweigh the potential problems is included. A focus on diagnosis is made with particular relation to diagnosing in Accident and Emergency (A & E) departments. Information is given on studies by the A & E department of Ulster Hospital on electrocardiograph interpretation and by the West Yorkshire Ambulance Service on defibrillation. Following MI several life-threatening arrhythmias can develop. Ventricular fibrillation accounts for the majority of sudden deaths which fail to reach hospital. The necessity for A & E staff to have a sound knowledge of the condition, its associated problems and to be effective in treating MI is promoted. The importance of rehabilitation programmes for victims of MI is highlighted and implications for the future of A & E department care concludes the article.