Description
Two readerships, both served
Roughly half our directory works where a STEMI goes to the catheter laboratory downstairs. The other half works where it goes into an ambulance, and their decisions — recognise, thrombolyse or not, stabilise, transfer, hand over — are just as consequential and far less written about.
These 437 pages address both, which is unusual for a primary PCI text.
For the transferring hospital
Recognition and the tracings that justify activating a distant lab. Whether to thrombolyse first when transfer time exceeds the window. What must be done before the ambulance departs, and what to hand over. These are decisions made by a doctor who will never see the angiogram, and they largely determine what the receiving operator is working with.
For the receiving operator
Acute access strategy. Thrombus management. Stent choice. Complete against culprit-only revascularisation on current evidence. No-reflow, with a full chapter. Shock complicating infarction. Post-procedure antithrombotic strategy.
The pathway chapters
Door-to-balloon time is a system property, not an operator property. The chapters on activation authority, parallel team assembly and transfer arrangement are the ones directory members in service leadership roles find most immediately actionable.
PDF, 437 pages, lifetime access, at CardiologyBooks.com.
Where the golden hour is actually lost
A primary PCI STEMI protocol rarely fails in the laboratory. It fails in the delays before it — the ECG not taken at triage, the activation call routed through three people, the transfer decision revisited, the consent conversation held twice. The book audits each interval, names the realistic target, and gives the system change that closes it.
In the laboratory and after
Access choice, thrombus management, the decision on non-culprit lesions, no-reflow and the shock patient are covered with the current evidence named. Antithrombotic selection and duration are set out for the common complicating situations — atrial fibrillation requiring anticoagulation, high bleeding risk, prior intracranial event — using DAPT, DAT and TAT terminology consistently. The final chapter covers the audit data a network must collect if its primary PCI STEMI protocol is to keep improving.
