Which class of medications commonly given to patients with acute coronary syndromes may be adversely affected by morphine administration A. Phosphodiesterase inhibitors B. Oral antiplatelet medications C. Beta blockers D. Calcium channel blockers ✔✔Oral antiplatelet medications What is a benefit of morphine when given for the management of acute coronary syndromes? A. Central nervous system analgesia B. Increases systemic vascular resistance C. Increases left ventricular preload D. Vasoconstriction ✔✔A. Central nervous system analgesia You obtain a 12-lead ECG in a patient with restrosternal chest pain. Which ECG finding is suggestive of high risk non ST segment elevation acute coronary syndromes A. ST depressions less than 0.5mm B. Dynamic T-wave inversion C. ST-segment elevation D. New bundle branch block ✔✔B. Dynamic T-wave inversion Upon reviewing a patient's 12 lead ECG, you note ST-segment elevation of 2mm in leads II,III, and aVF How would you classify the electrocardiographic findings A. Normal B. STEMI C. Non-STEMI D. Non-diagnostic ✔✔b. STEMI What happens when teams rapidly assess and intervene when patients have abnormal vital signs ✔✔The number of in hospital cardiac arrests decreases What is the goal for first medical contact-to-ballon inflation time for a patient receiving PCI ✔✔90 minutes What is the longest acceptable emergency department door-to-needle time when fibrinolysis is the intended reperfusion strategy ✔✔30 minutes What is the time goal for how quickly you should complete a fibronolytic checklist once the patient arrives in the emergency department ✔✔10 minutes What is the recommended time window after symptom onset for early fibronolytic therapy or direct catheter-based reperfusion for patients with STEMI and no contraindication ✔✔Within 12 hours a 49 yo says that he has had chest discomfort and excessive sweating for the past 25 minutes. Within the first 10 minutes, on the basis of the patient showing symptoms suggestive of MI, what will your first actions include? ✔✔Provide prehospital notification to the receiving hospital Administer aspirin if considering prehospital fibrinolysis, use the fibrinolytic checklist assess ABC Obtain EKG consider oxygen, nitroglycerin, and morphine if needed His initial vital signs are HR 120/min BP 135/88 RR 23 O2 87% When considering oxygen saturation, what is your course of actions? ✔✔Start oxygen at 4L What additional questions help you determine next steps ✔✔When did the symptoms start Do you take any medication Do you have any allergies Your patient continues to say that he has chest discomfort What treatment can you repeat as long as it is not contraindicated by vital signs ✔✔Nitroglycerin sublingual every 3-5min What is your interpretation of the patient's EKG tracing STEMI in V2-6 ✔✔Anterior STEMI With the possible diagnosis of STEMI, what is the most probable treatment ✔✔Admission for PCI/fibrinolysis After you give report to the hospital, staff advise you to proceed to the cath lab for PCI What is the goal for PCI when treating this patient ✔✔First medical contact to balloon inflation time of 90 minutes Which action is part of the secondary assessment of a conscious patient ✔✔Formulate a differential diagnosis What is the most common type of stroke ✔✔Ischemic stroke What is the recommended time window after symptom onset for early fibrinolytic therapy or direct catheter based reperfusion for patients with STEMI and no contraindications ✔✔12 hours What validated, abbreviated out of hospital neurologic evaluation tool contains 3 components: facial droop, arm drift, and abormal speech test ✔✔Cincinnati Prehospital Stroke scale What is the estimated probability of the CPSS with 1 abnormal finding when scored by prehospital providers ✔✔72% Which is a stroke severity tool that helps EMS differentiate large vessel occlusion stroke from non-large vessel occlusion stroke ✔✔Los Angeles Motor Scale What is the primary advantage of using a stroke severity tool? ✔✔It helps ID large vessel occlusion stroke