Use of thrombolytics by GPs in suspected myocardial infarction:

by Dr. Lawrence on November 8, 2010

in Cardiology,Medicine

The use of thrombolytics by GPs in the management of suspected myocardial infarction is indicated if:

A. More than 12 hours have elapsed since the onset of pain
B. Clinical suspicion remains despite a normal ECG
C. Intramuscular opiates have been given 
D. ‘The call to needle time’ will exceed 90 minutes

The Correct Answer is D

General practitioners (though not at present ambulance paramedics) may wish to start thrombolytic treatment outside hospital providing that they have facilities for managing arrhythmia and for resuscitation, including defibrillators (which may be provided by an attending ambulance); they can accurately diagnose acute myocardial infarction by using clinical and electrocardiographic criteria; and they believe that pre-hospital treatment in each case will result in an appreciable time saving, particularly if this is the only way of achieving a 90 minute “call to needle” time.

The call to needle time should ideally be no longer than 60 minutes, but 90 minutes is a reasonable target for those patients with a readily diagnosed acute myocardial infarction.

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{ 2 comments… read them below or add one }

amel mohd January 20, 2012 at 6:06 pm

please give us more mcq in medicines
with thanks

Reply

Dr. Lawrence February 19, 2012 at 3:46 am

Hi Amel,

Will try to post more mcqs soon.

Reply

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