Aspirin should be initiated as soon as possible and continued indefinitely in patients who tolerate it. (Level A)
Clopidogrel loading dose should be initiated as soon as possible in patients unable to tolerate aspirin.  (Level B)
Medium/High risk patients in whom initial invasive strategy is planned should receive dual therapy (Level A) including aspirin (Level A) and:
Before PCI one of the following:
Clopidogrel (Level B)
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Otherwise during PCI one of the following:
Clopidogrel (Level A) if not started beforehand
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Prasugrel (Level B)
If an initial conservative (i.e. noninvasive) strategy is selected, clopidogrel should be added to ASA and anticoagulant therapy as soon as possible after admission. (Level B)
If an initial conservative strategy is selected and recurrent symptoms/ischemia, heart failure, or serious arrhythmias subsequently appear, then diagnostic angiography should be performed. (Level A). Either an IV GP IIb/IIIa inhibitor (Level A) or clopidogrel (Level B) should be added to ASA and anticoagulant therapy before diagnostic angiography. (Level C)
Before PCI one of the following:
Clopidogrel (Level B)
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Otherwise during PCI one of the following:
Clopidogrel (Level A) if not started beforehand
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Prasugrel (Level B)
Clopidogrel (Level B)
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Clopidogrel (Level A) if not started beforehand
An IV GP IIb/IIIa inhibitor (Level A) preferably eptifibatide or tirofiban.
Prasugrel (Level B)
Unstable Angina - NSTEMI Guidelines
ACS - Risk Stratification
Harbor Macros: EKG
ACS - Stress Testing
Maine:Prehospital protocol pediatric shock
Harbor Macros: Chest Pain
Maine:Prehospital protocol pediatric stridor
ECGs by Diagnosis