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    Emergency Department Management of Patients Needing Reperfusion Therapy for Acute ST-Segment Elevation Myocardial Infarction

    Official 2017 guideline from the American College of Emergency Physicians.

    summary by Eric Steinberg, DO, MEHP

    Recommendations

    Fibrinolytics for Delayed PCI

    Level B

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    Level C

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    Transfer to PCI Center

    Level B

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    Opioid Use

    Level C

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    Level A
    Generally accepted principles for patient care that reflect a high degree of clinical certainty (eg, based on evidence from one or more Class of Evidence I or multiple Class of Evidence II studies).
    Level B
    Recommendations for patient care that may identify a particular strategy or range of strategies that reflect moderate clinical certainty (eg, based on evidence from one or more Class of Evidence II studies or strong consensus of Class of Evidence III studies).
    Level C
    Recommendations for patient care that are based on evidence from Class of Evidence III studies or, in the absence of any adequate published literature, based on expert consensus. In instances in which consensus recommendations are made, “consensus” is placed in parentheses at the end of the recommendation.