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Remote STEMI transfer — DipIMC MCQ

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ModerateRetrieval MedicineRemote STEMI transferDipIMC

A remote island patient has an anterior STEMI. Ferry transfer to the PCI centre will take four hours; air transfer can reach the PCI centre in 50 minutes and weather is within limits. What is the most appropriate transport decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Arrange air transfer to the PCI centre if operationally safe

STEMI care is time-dependent, so air transfer is appropriate when it materially reduces time to reperfusion and is operationally safe. Troponin confirmation is not required when ECG and symptoms support STEMI pathway activation. Observation without reperfusion access risks avoidable myocardial loss. The pearl is that retrieval systems can be a core part of reperfusion medicine in remote settings.

Reference: JRCALC Guidelines 2025; NICE Acute Coronary Syndromes NG185