Interventional & Acute Care

The first hour, and the laboratory it often ends in. This section covers STEMI recognition and reperfusion decisions when transfer times are long, cardiogenic shock, primary angioplasty protocols, and the complications that appear during or after intervention. It is written for the doctor who is the acute cardiac service that night, whether in an emergency department, a district hospital or a single-operator catheterisation laboratory. Frequently kept within reach are Cardiac Emergency First Hour Protocols and the primary angioplasty golden hour protocol. Elective technique is covered in Interventional Cardiology.
Written for the interval before the specialist arrivesInterventional and acute care titles cover the period in which outcome is actually determined: the first ECG, the activation call, the transfer decision, the first sixty minutes of shock or tachyarrhythmia. Doses, infusion rates and escalation triggers are stated in full rather than referenced elsewhere, because a protocol requiring a second lookup is not a protocol. The catheterisation laboratory material covers access choice, thrombus management, no-reflow, the non-culprit lesion decision, and the complications that announce themselves late — perforation, retroperitoneal bleeding, quiet dissection. Antithrombotic selection uses DAPT, DAT and TAT terminology consistently and addresses the common complicating situations of atrial fibrillation, high bleeding risk and prior intracranial event.