STEMI-2017/C2/Importance-of-Fibrinolytic-Checklist/English

Topic: Importance of Fibrinolytic Checklist

Contributor Name: Jerry David, STEMI Team, Coimbatore

Reviewed by: Nancy Varkey, Spoken Tutorial Project, IIT Bombay

Keywords: STEMI, STEMI App, Data entry in STEMI App, New Patient Tab, Fibrinolytic Checklist, Systolic & Diastolic B.P, CPR, Cardiogenic Shock, PCI.

Visual Cue	Narration
Show Title Importance of Fibrinolytic checklist	Hello and welcome to this tutorial on the Importance of Fibrinolytic Checklist.
Show Learning Objectives Slide	In this tutorial, we will learn about The various criteria listed in Fibrinolytic Checklist
Show System Requirements Slide	To practise this tutorial, you will need - An Android tablet with STEMI App installed on it and A working Internet connection.
Pre-requisite slide	You will also need to have working knowledge of the STEMI device and the STEMI App. If not, please refer to the STEMI tutorial series on this website.
Switch to STEMI device homepage	This is our STEMI Homepage.
Select New Patient tab.	Let’s select New Patient tab.
Under New Patient Tab Patient Details appear	Under New Patient tab, Patient Details appears.
Select Fibrinolytic Checklist. Fibrinolytic checklist page	Select Fibrinolytic Checklist. The Fibrinolytic checklist comes under the main Patient Details tab after Basic Details. 13 points - “Pregnant female” Under Fibrinolytic checklist - If the patient was female 13 items would be displayed If the patient was male 12 items would be displayed. It is a relative or absolute contraindication for thrombolysis. When Hub/ Spoke hospitals are close together, then if any of these 13 points are marked as ‘Yes’ it would be preferable to shift the patient to a Hub hospital.
Let’s take a look at the following 1. Systolic BP greater than 180 mmHg: 2. Diastolic BP greater than 110 mmHg: 3. Right Vs Left arm Systolic BP greater than 15 mmHg: 4. Significant closed head/facial trauma within previous 3 months 5. Recent (within 6 weeks) major trauma, surgery (including eye surgery), GI/GU bleed: 6. Bleeding or Clotting problem or on blood thinners: 7. CPR greater than 10 min: 8. Pregnant Female: 9. Serious systemic disease (e.g., advanced/ terminal cancer, severe liver or kidney disease: 10. History of structural central nervous system disease: The next three points 11. Pulmonary edema (rales greater than halfway up) 12. Systemic Hypoperfusion (cool, clammy) 13. Does the patient have severe heart failure or cardiogenic shock such that PCI is preferable?	Let’s take a look at these 13 points 1.Systolic BP greater than 180 mmHg: check BP 2.Diastolic BP greater than 110 mmHg: Similarly check BP 3.Right Vs Left arm Systolic BP greater than 15 mmHg: this won’t be possible in an ambulance, but in a hospital check BP 4.Significant closed head/facial trauma within previous 3 months: ask the patient or his/her relatives 5.Recent (within 6 weeks) major trauma, surgery (including eye surgery), GI/GU bleed: ask the patient or his/her relatives 6.Bleeding or Clotting problem or on blood thinners: again ask the patient or his/her relatives 7.CPR greater than 10 min: in case of a cardiac arrest the patient requires resuscitation more than 10 minutes 8.Pregnant Female: in case of Female patients below the age of 50, check for pregnancy 9.Serious systemic disease (e.g., advanced/ terminal cancer, severe liver or kidney disease: ask the patient or his/her relatives 10. History of structural central nervous system disease: again, ask the patient or his/her relatives The next three points are for doctors and if a doctor is available, ask to check for these: 11. Pulmonary edema (rales greater than halfway up) 12. Systemic Hypoperfusion (cool, clammy) 13. Does the patient have severe heart failure or cardiogenic shock such that PCI is preferable?
	Let us summarize.
Show Summary Slide	In this tutorial, we have learnt about - The importance of Fibrinolytic checklist The various criteria listed in Fibrinolytic Checklist
Show STEMI INDIA slide	STEMI INDIA was set up as a ‘not for profit’ organisation primarily to reduce delays in accessing appropriate care for heart attack patients and reducing deaths due to heart attacks.
Show Spoken Tutorial Project Slide	Spoken Tutorial Project, IIT Bombay is funded by NMEICT, MHRD, Govt. of India. For more details, please visit http://spoken-tutorial.org
Show THANK YOU slide	This tutorial has been contributed by STEMI INDIA and the Spoken Tutorial Project, IIT Bombay. This is Nancy Varkey signing off. Thanks for joining.

Contributors and Content Editors

Nancyvarkey, PoojaMoolya