73. ST Elevation Baseline Ischemia —tall or inverted T wave (infarct), ST segment may be depressed (angina) Injury —elevated ST segment, T wave may invert Infarction (Acute) —abnormal Q wave, ST segment may be elevated and T wave may be inverted Infarction (Age Unknown) —abnormal Q wave, ST segment and T wave returned to normal
Epinephrine (Class Indeterminate) 1 mg IV push every 3 to 5 minutes. If this fails, higher doses of epinephrine (up to 0.2 mg/kg) are acceptable but not recommended (there is growing evidence that it may be harmful). Vasopressin is recommended only for VF/VT; there is no evidence to support its use in asystole or PEA. There is no evidence about The value of repeated vasopressin doses or The best approach after the first single bolus of vasopressin As a Class Indeterminate action, it is acceptable to resume epinephrine 1 mg IV push every 3 to 5 minutes if there was no response in 5 to 10 minutes to a single IV dose of vasopressin. The evidence for this approach is based on rational conjecture. Suggestion to instructors Resist the requests to tell the learners whether you prefer epinephrine or vasopressin. The evidence, as of 2001, makes them equivalent, with vasopressin, as a nonadrenergic agent, associated with fewer adverse side effects. The supply chain from production to widespread distribution throughout all hospitals and the EMS system has been slow to develop.