Question

A 58-year-old man presents to a remote nursing station in northern Canada with chest pain suspicious for STEMI. The nearest hospital is 3 hours away by air. There is no on-site thrombolytic agent stocked. What is the most appropriate action for the rural physician or nurse practitioner?

Accepted Answer

Arrange urgent transfer and concurrently advocate for system changes to ensure thrombolytics and protocols are available locally in future

Answer

Provide analgesia only and wait for the medevac team

Answer

Tell the patient nothing more can be done and arrange routine transfer

Answer

Attempt to manage with aspirin alone

Answer

Wait to confirm the diagnosis before arranging transfer

Practice question

A 58-year-old man presents to a remote nursing station in northern Canada with chest pain suspicious for STEMI. The nearest hospital is 3 hours away by air. There is no on-site thrombolytic agent stocked. What is the most appropriate action for the rural physician or nurse practitioner?