Enhancing prehospital ACS management: Insights from the 2023 ESC guidelines

Abstract

Aim: This paper aims to elucidate the key changes and insights from the 2023 European Society of Cardiology (ESC) guidelines for prehospital management of Acute Coronary Syndromes (ACS). Material and methods: The guidelines are thoroughly analyzed, focusing on diagnostic tools, treatment strategies, and pharmacological interventions. Specific attention is given to the utilization of electrocardiogram (ECG) in ACS diagnosis, oxygen therapy thresholds, the use of nitrates and contraindications, morphine and alternative pain management, aspirin administration, and the application of beta-blockers and benzodiazepines. Results: The guidelines emphasize the critical role of the 12-lead ECG in early ACS diagnosis, categorizing patients based on ST-segment elevation. Revised oxygen supplementation protocols and cautious use of nitrates are highlighted, considering their potential harmful effects. Alternatives to morphine for pain management and the importance of prompt aspirin administration are stressed. The guidelines also advocate for the use of intravenous beta-blockers in certain patients and recognize the role of benzodiazepines in managing stress-related symptoms. The importance of rapid treatment in reperfusion strategies and the use of ECG telemetry in enhancing communication with medical facilities are underscored. Conclusions: The 2023 ESC guidelines present a comprehensive and updated approach to the prehospital management of ACS. They emphasize the need for rapid and accurate diagnosis, judicious use of pharmacological interventions, and the importance of standardized care protocols. These guidelines are pivotal in improving patient outcomes, reducing mortality and morbidity, and necessitate continued education and adaptation by emergency medical personnel.