American College of Cardiology

Antman et al., Management of Patients With STEMI: Executive Summary
J Am Coll Cardiol 2004;44:671-719

ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)

Developed in Collaboration With the Canadian Cardiovascular Society


Onset of STEMI

A. Out-of-Hospital Cardiac Arrest

Class I
1. All communities should create and maintain a strong “Chain of Survival” for out-of-hospital cardiac arrest that includes early access (recognition of the problem and activation of the EMS system by a bystander), early cardiopulmonary resuscitation (CPR), early defibrillation for patients who need it, and early advanced cardiac life support (ACLS). (Level of Evidence: C)

2. Family members of patients experiencing STEMI should be advised to take CPR training and familiarize themselves with the use of an automated external defibrillator (AED). In addition, they should be referred to a CPR training program that has a social support component for family members of post-STEMI patients. (Level of Evidence: B)

The links in the chain include early access (recognition of the problem and activation of the EMS system by a bystander), early CPR, early defibrillation for patients who need it, and early ACLS.