Paramedic National Registry Practice

You have a patient with 4mm ST elevation in II, III and AVF with chest pain and a BP of 86; what is your treatment?

1. Administer nitroglycerin

2. Administer aspirin

3. Fluid bolus

4. Start CPR immediately

The correct answer is: Fluid bolus

In the scenario presented, the patient is exhibiting signs of inferior ST elevation myocardial infarction (STEMI) indicated by the ST elevation in leads II, III, and aVF, coupled with chest pain and hypotension (a blood pressure of 86). In this situation, the appropriate treatment focuses on addressing the patient's potential for inadequate perfusion resulting from low blood pressure. Administering a fluid bolus is indicated to help increase the intravascular volume, which can improve the blood pressure and enhance perfusion to vital organs. This approach is particularly critical in patients who are hypotensive, as it may help stabilize their condition before further intervention or advanced care, such as medication administration or procedural interventions like percutaneous coronary intervention. While nitroglycerin and aspirin may be important in the overall management of a myocardial infarction, in this instance, administering nitroglycerin might exacerbate hypotension due to its vasodilatory effects. Aspirin plays a role in reducing the risk of thrombus formation but will not directly address the immediate concern of low blood pressure. Starting CPR immediately is reserved for patients who are in cardiac arrest, which is not indicated here as the patient is conscious with chest pain. Therefore, the best choice is to initiate