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STEMI Alert check list

ST Elevation present? ______ yes ______ no

In which Leads?
_____ II ____III _____AVF _____V1 _____V2 _____V3 _____V4 _____V5 _____V6

LBBB present? ______ yes ______ no

If yes is the answer for one or both questions = STEMI ALERT

________________________________________________________________________________

CP Information

Onset of CP? _____ min. ______ hours

Time of first 12-Lead? ____:_____

What were they doing when the CP started?_____________

Description of CP? ___________________

Radiation? _____ yes ______ no

Does anything make it better?____________

NTG taken prior to arrival? _____ yes _____ no

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