NSTEMI / Unstable Angina

Risk-stratify with GRACE

First 30 seconds

  1. 1ECG, troponin
  2. 2Aspirin 300 mg + ticagrelor 180 mg
  3. 3Fondaparinux 2.5 mg SC
  4. 4Pain relief, oxygen if hypoxic

ACS without ST elevation: troponin rise (NSTEMI) or normal (UA).

A

Airway

  • Patent? Talking? Stridor?
  • Suction, jaw-thrust, adjuncts, definitive airway if needed
B

Breathing

  • RR, SpO₂, auscultate, percuss
  • O₂ to target sats, NIV / intubate as required
C

Circulation

  • HR, BP, cap refill, JVP
  • 2× large-bore IV, bloods, monitor, ECG
D

Disability

  • AVPU/GCS, pupils, glucose, temp
E

Exposure

  • Full exposure, skin, rash, bleeding, lines, infection source
View flowchart algorithm
WardRound

WardRound

Clinical Decisions in Seconds