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Remote STEMI reperfusion — DipIMC MCQ

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ModerateRetrieval and Transport MedicineRemote STEMI reperfusionDipIMC

A man on a remote island has inferior STEMI and PCI cannot be achieved within the local target time. Local policy includes pre-hospital thrombolysis if eligible. What is the most appropriate management?

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

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Correct answer: C — Follow the local reperfusion pathway, considering thrombolysis if eligible

Option C is correct because When timely PCI is not feasible, local STEMI pathways may use thrombolysis after contraindication screening. Option B is less appropriate because watchful waiting risks deterioration or delays definitive care; option A is less appropriate because the clinical risk exceeds that destination or timeframe. Option E is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option D is less appropriate because analgesia is important but not sufficient as the primary intervention. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; local STEMI network protocols