ACLS Megacode 7: STEMIHurry, don’t let time run out!Sorry, time is up!0 Hours 0 Minutes 0 SecondsStep 1 of 520%Pt arrives to ED/Casualty with diaphoresis, midsternal chest pain radiating to left arm and jaw.1. What are the best diagnostic / therapeutic first steps?*IV, chest xray, sl NTG, Arterial blood gasIV, SL ntg , IV beta blockerGive 4 (81mg) Aspirin tablets, 12 lead ekg, IV, oxygenIV, CT scan chest , heparinPt is a 54 y/o male, smoker, c/o chest heaviness ,diaphoresis, nausea present to ED/casualty via paramedics.IV placed an EKG has been done in Triage.2. Interpret the ekg and choose the best therapies:*Acute anterior STEMI, Aspirin, contact Cardiology for Lytic therapy or emergent cardiac angiography and intervention.Non-diagnostic EKG, admit for observation and stress test.NSTEMI, aspirin, statin, beta blocker and cardiology consultAcute inferior STEMI, SL ntg, morphine and beta blocker62 y/o woman with diabetes presents to ED/Casualty with epigastric discomfort, nausea and vomiting.BP: 150/80 P: 85 R:22 O2: 100% Temp: 36.7After she is seen by the Surgical resident, she develops hypotension BP 90/50 and an ekg is performed.3. What should be done urgently?*Inferior STEMI, aspirin, IV fluid bolus, cardiology consultNSTEMI, aspirin, Beta blocker and heparinInferior STEMI, aspirin, iv diuretics, beta blocker , morphine and cardiology consultAnterior STEMI, IV diuretics, SL NTG, IV beta blocker, lytic therapyOn the next rhythm check, the patient demonstrates the following rhythm: She now has a palpable pulse but is hypotensive, unresponsive, and hypoxic.4. What are the next appropriate steps in management?*Intubate and give amiodaroneCardiovert, prepare to intubateDefibrillate, prepare to intubateIntubate and continue CPRAfter cardioverting and intubating, you get an EKG which demonstrates the following: You re-assess the patient and cannot palpate a pulse.5. What is the next step?*AmiodaroneDefibrillateCardiovertEpinephrine This iframe contains the logic required to handle Ajax powered Gravity Forms.
