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Post-arrest STEMI — DipIMC MCQ

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ModerateResuscitationPost-arrest STEMIDipIMC

A 58-year-old man is resuscitated from VF at home. He has ROSC, ongoing ST elevation on 12-lead ECG and remains hypotensive but ventilated. What is the most appropriate transport decision?

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Correct answer: D — Transport to a centre capable of emergency coronary angiography with critical care pre-alert

ROSC after VF with ST elevation suggests acute coronary occlusion requiring a pathway to emergency reperfusion and post-arrest care. Scene delay for ECG normalisation is inappropriate. ROSC is the beginning of a high-risk post-arrest phase, not the endpoint. The pearl is that destination after ROSC should match both the likely cause and the patient’s critical care needs.

Reference: Resuscitation Council UK Post-resuscitation Care Guidelines 2025; JRCALC Guidelines 2025