Acute coronary syndrome — DipIMC MCQ

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EasyMedical EmergenciesAcute coronary syndromeDipIMC

A 61-year-old has central crushing chest pain radiating to the left arm while hiking. He is clammy, nauseated and has no history of aspirin allergy or major bleeding. What is the most appropriate drug/dose?

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Correct answer: C — Give aspirin 300 mg to chew and arrange urgent cardiac pathway transfer

Give aspirin 300 mg to chew and arrange urgent cardiac pathway transfer is the best answer because suspected acute coronary syndrome should receive aspirin unless contraindicated and rapid pathway activation. Give oral antihistamine as first-line treatment is less appropriate because antihistamines do not treat airway, breathing or circulation compromise; Give intravenous adrenaline 1 mg as a rapid bolus is less appropriate because IV bolus adrenaline is reserved for cardiac arrest or expert titrated use. Give nebulised salbutamol as sole treatment and Delay medication until hospital review are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Clinical Knowledge Summaries