Within the first 10 minutes, based on the patient showing symptoms suggestive of myocardial
ischemia, what will your first actions include (if not completed by EMS before arrival)?
Obtain a 12-lead electrocardiogram (ECG)
Administer a blood thinner
Administer aspirin and establish IV access
Activate the ST-segment elevation myocardial infarction (STEMI) team
If SPO2 is less than 90%, start oxygen
Assess airway, breathing, and circulation (ABCs)
Administer epinephrine 1 mg IV
Consider nitroglycerin, morphine, and a P2Y inhibitor
ANSWER:
Obtain a 12-lead electrocardiogram (ECG)
Administer aspirin and establish IV access
Activate the ST-segment elevation myocardial infarction (STEMI) team
If SPO2 is less than 90%, start oxygen
Assess airway, breathing, and circulation (ABCs)
Consider nitroglycerin, morphine, and a P2Y inhibitor
His initial vital signs are HR 120/min, BP 135/88 mm Hg, RR 23/min, SpO2 87%, and
temperature 37.3C. When considering oxygen saturation, what is your course of action?
Intubate the patient immediately
Administer albuterol nebulizer
Do not start oxygen
Start oxygen at 4L/min via nasal cannula
ANSWER:
Start oxygen at 4L/min via nasal cannula
What additional questions help you determine next steps?
Do you take any medications?
Do you have any allergies?
When was the last time you went to the doctor?
When did the symptoms start?
, ESTUDY
Have you had any recent falls?
ANSWER:
Do you take any medications?
Do you have any allergies?
When did the symptoms start?
Your patient continues to say that he has chest discomfort. What treatment can you repeat as
long as it is not contradicted by vital signs?
Morphine sublingual every 1 to 3 minutes
Morphine IV every 1 to 3 minutes
Nitroglycerin sublingual or translingual every 3 to 5 minutes
Nitroglycerin every 1 to 3 minutes
ANSWER:
Nitroglycerin sublingual or translingual every 3 to 5 minutes
What is your interpretation of the patient's ECG tracing?
With the diagnosis of STEMI, what is the most probable treatment?
Release to home
Admission to an intensive care unit
Admission for observation
Admission for PCI or fibrinolysis
ANSWER:
Admission for PCI or fibrinolysis
What is your goal for PCI when treating this patient?
Door-to-balloon inflation time of 30 minutes
First medical contact-to-balloon inflation time of 90 minutes
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