AMI

Question 1

List 8 measures in ED in managing 80 yr F with inferior and posterior STEMI ,
BP 80/50 , RR 18, sat 96%RA , temp 36

Answer 1

1-activate cath lab ,
2-prepare for pacer or defibrilate
3-IVF : 250 ml normal saline boluses to assist preload but avoid overload
4-analgesia :2.5-5 mg morphine IV boluses titrated to pain
5-aspirin 300 mg orally
6-heparin 5000 units IV
7-atropine 600-1200 mcgIV aim for hr >60
8-adrenaline infusion ( aim for SBP>90 )
9-check and treat electrolytes

Question 2

indications for immediate transfer to PCI centre post thrombolysis

Answer 2

ongoing chest pain

non resolution of STE

Question 3

Indications for thrombolysis in PCI centre

Answer 3

Unable to get into cath lab

unable to mobilise staff /already in use