STEMI destination — DipIMC MCQ

Correct answer: C — Convey to the primary PCI centre with pre-alert

Explanation lettering: B = shown as A · D = shown as B · E = shown as D · A = shown as E

C is correct: Stable STEMI should follow direct primary PCI pathways when reachable within system standards. A is less suitable because it moves the patient before the decisive threat or destination issue is addressed; B is less suitable because it moves the patient before the decisive threat or destination issue is addressed; D is less suitable because it does not address the discriminator in the vignette; E is less suitable because it does not address the discriminator in the vignette. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; Resuscitation Council UK; NICE guidance where applicable