A 55-year-old man with myocardial infarction is retrieved from a rural hospital.
He received aspirin, heparin and intravenous morphine in appropriate doses and was given tenecteplase one hour and 45 minutes ago.
On arrival to your tertiary ED he looks pale and sweaty and has severe chest pain. His arrival ECG is displayed below.
Arrival ECG after thrombolysis.
What is the main pathology demonstrated?
(Marked out of 1.0)
/ 1
List four ECG features that support your answer.
(Marked out of 4.0)
/ 4
His vital signs are GCS 15, BP 80/40 mmHg and oxygen saturation 99% on 6 L/min oxygen by Hudson mask. List three management steps you would perform and justify each.
(Marked out of 6.0)
/ 6
Shortly after arrival he develops complete heart block with a ventricular escape rhythm. His observations are GCS 14 (E4 V4 M6), pulse 30/min and BP 70/35 mmHg. You decide to electrically pace him. State five steps in successful initiation of electrical pacing.
(Marked out of 5.0)
/ 5
Total Score: 0 / 16
Percentage: 0%
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