Medications
If the patient with ACS begins to develop shock and is unable to protect his/her airway, then you might have to perform endotracheal intubation (Refer to Airway Management CPG). The following considerations should be made regarding induction and post-intubation sedation medications:41
Ventilator Settings
High intrathoracic pressures affect the right and left ventricles differently. High intrathoracic pressures impair right ventricular filling, yet reduces left ventricular afterload. In a patient’s post-MI that require mechanical ventilation, minimization of intrathoracic pressures for a patient with inferior/right ventricular infarction is essential to maintain cardiac output. PEEP and tidal volume should be minimized as much as possible.