Interventional cardiologist here in Florida in practice 8 years. I appreciate your videos. They have definitely helped many of my patients. Several of us routinely talk about your videos at the hospital.
Thank you for another great video. I have a question. Typically ACS/STEMI patients are not fasted. They may receive pain relief en route to hospital. In prior videos you have mentioned delayed gastric emptying and possible delays in oral dosing of anti-platelet meds etc. If a patient becomes acutely unwell with a full stomach and is rushed to cath lab, does this increase risk of aspiration especially if they need to be shocked. My question therefore relates to management of the unfasted patient. E.g.. would it be safer to administer medication that speeds up gastric emptying and administer anti-platelet therapy IV? Thank you.
This could possibly help - it is always a balance between risk of bleeding and potential benefit. Would not give routinely IV antiplatelet agents, but sometimes they are helpful especially in the setting of large thrombus burden.
Sometimes after numerous thrombus aspirations, the thrombus is still visible and flow remains sluggish. How often do you use intracoronary/intravenous GPIIbIIIa? Do you defer stenting?
