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Within the first 10 minutes, on the basis of the patient showing symptoms suggestive of
myocardial ischemia, what will your first actions include (if not completed by EMS before
arrival)?
o Obtain a 12-lead electrocardiogram (ECG)
o Administer a blood thinner
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o Administer epinephrine 1 mg IV
o Consider nitroglycerin, morphine and a P2Y inhibitor - ✔✔✔ANSW✔✔..o Obtain a 12-
lead electrocardiogram (ECG)
o Administer aspirin and establish IV access
o Activate the ST-segment elevation myocardial infarction (STEMI) team
o If SPO2 is less than 90%, start oxygen
o Assess airway, breathing, and circulation (ABCs)
o 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?
o Intubate the patient immediately
o Administer albuterol nebulizer
o Do not start oxygen
o Start oxygen at 4L/min via nasal cannula - ✔✔✔ANSW✔✔..o Start oxygen at 4L/min
via nasal cannula
What additional question help you determine next steps?
o Do you take any medication?
o Do you have any allergies?
o When was the last time you went to the doctor?
o When did the symptoms start?
o Have you had any recent falls? - ✔✔✔ANSW✔✔..o Do you take any medication?
o Do you have any allergies?
o 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?
o Morphine sublingual every 1 to 3 minutes
o Morphine IV every 1 to 3 minutes
o Nitroglycerine sublingual or translingual every 3 to 5 minutes
o Nitroglycerine every 1 to 3 minutes - ✔✔✔ANSW✔✔..o Nitroglycerine sublingual or
translingual every 3 to 5 minutes
What is your interpretation of the patient's ECG tracing?
o Anterior ST-segment elevation of myocardial infarction (STEMI)
o Ventricular tachycardia
o Posterior ST-segment elevation myocardial infarction (STEMI)
o Normal sinus rhythm with premature ventricular contractions - ✔✔✔ANSW✔✔..o
Anterior ST-segment elevation of myocardial infarction (STEMI)
You find the patient's neurologic function is rapidly improving. Is this patient still a
candidate for fibrinolytic therapy?
o Yes
o No
o Not enough information - ✔✔✔ANSW✔✔..o No
Because this patient is no longer a candidate for fibrinolytic therapy, what are your next
steps for him?
o Consider giving adenosine
o Administer O2
o Support airway, breathing, and circulation (ABCs_
o Begin the stroke pathway
o Admit the patient to an intensive care unit
o Order an emergent x-ray
o Order an emergent CT scan - ✔✔✔ANSW✔✔..o Support airway, breathing, and
circulation (ABCs_
o Begin the stroke pathway
o Admit the patient to an intensive care unit
As Team Leader, you conduct the primary assessment, including rhythm analysis, while
high-quality BLS continues. What type of rhythm is being displayed on the monitor?
o Ventricular tachycardia
o Asystole
o Supraventricular tachycardia
o Ventricular fibrillation - ✔✔✔ANSW✔✔..o Ventricular fibrillation
Based on the patient's condition, what is your next action?
o Pause CPR to establish IV/IO access
o Continue CPR while you establish IV/IO access
o Shock immediately
o Continue CPR while delivering shock - ✔✔✔ANSW✔✔..o Shock immediately