ST-elevation myocardial infarction destination — DipIMC MCQ

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

Transport directly to the primary PCI centre with pre-alert is the best answer because confirmed STEMI should usually bypass non-PCI facilities when timely primary PCI is available. Allow self-evacuation in a private vehicle is less appropriate because private transport is unsafe for an unstable or potentially unstable casualty; Delay transport for full wound cleaning is less appropriate because wound toilet should not delay urgent haemorrhage or surgical care. Transport to the nearest hospital without pre-alert and Remain on scene until observations normalise 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 Acute Coronary Syndromes guidance