St. Segment Elevation Myocardial Infarction (STEMI)

Patient Self-Administration of Medicine Although patient empowerment is valuable, it is essential that hospitals exercise control over the medications patients take. It is impossible to design an effective plan of care otherwise. However, many patients wish to self-administer medications within the hospital setting. For many patients, self-administration is a reasonable goal at home: it is particularly necessary for chronic conditions like diabetes, where patients must learn to self-administer their medications to remain independent over the course of their lives.

There also appears to be a desire amongst patients to take control over their own medications even in a hospital context. In a qualitative study of self-medication: "seven participants had previously experienced self-administration of medications and six were in favour of this practice in the clinical setting. Nine managed their own medications at home, and one self-administered with some assistance from his family.

Participants were very concerned about how nurses' heavily regulated routines affected delivery of medications in hospital and disrupted individualized plans of care maintained in the home setting" (Beanland, Riley, & Baker 2004). This discrepancy in attitude (a desire amongst nurses for control and amongst patients for the ability to not lose direction over their care, even when in an institutional context) makes self-administration an important topic for study. These two competing desires must be balanced with compassion and efficacy References Beanland, M.E., Riley, R., & Baker, L. (2004).

Self-administration of medication in hospital: patients' perspectives. Journal for Advanced Nursing, 46(2):194-203. Q2. ST segment Elevation Myocardial Infarction (STEMI) There are two types of heart attacks: a ST segment Elevation Myocardial Infarction (STEMI) is the most lethal kind. " Myocardial infarctions (heart attacks) occur when a coronary artery suddenly becomes at least partially blocked by a blood clot, causing at least some of the heart muscle being supplied by that artery to become infarcted (that is, to die)" (Fogoros 2014).

'Death' of the muscle takes place very quickly, thus expediency in diagnosis and treatment is literally a matter of life and death. STEMI can usually be detected with an EKG: "One of those ECG changes is a characteristic elevation in what is called the 'ST segment.' The elevated ST segment indicates that a relatively large amount of heart muscle damage is occurring (because the coronary artery is totally occluded), and is what gives this type of heart attack its name" (Fogoros 2014).

Because the earlier detection of STEMI, the better, various points of care and interaction with the healthcare system have been studied, to determine when and how to improve detection. Recent research indicates that EMS staff can play a critical role in improved detection and earlier treatment of STEMIs, thus resulting in better patient outcomes. According to Ducas (et al. 2012).