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Question preview · ACEM Fellowship

A 60-year-old man presents to the emergency department with 90 minutes of central crushing chest pain radiating to the left arm. ECG shows ST elevation in leads V2–V5. The nearest percutaneous coronary intervention (PCI) centre is 3 hours away by road and retrieval is delayed due to weather. According to Australian acute coronary syndrome guidelines, what is the most appropriate immediate reperfusion strategy?

  1. A. Arrange transfer for primary PCI despite the anticipated delay
  2. B. Administer thrombolysis with tenecteplase as soon as possible and arrange transfer after lysis
  3. C. Give aspirin alone and await retrieval
  4. D. Commence a heparin infusion and wait for PCI
  5. E. Provide strong opioid analgesia only while awaiting cardiology advice

This is a real question from the ACEM Fellowship sample bank. Start a guided session to answer a sample question, then explore your reasoning with Tutor.

  1. Answer a question for ACEM Fellowship.
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  3. Keep your question and explanation beside the conversation.
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