TX for a patient experiencing an MI

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Multiple Choice

TX for a patient experiencing an MI

Managing a patient with an MI focuses on relieving pain, reducing myocardial oxygen demand, improving oxygen delivery, and starting antithrombotic therapy to limit heart muscle damage. The most practical initial approach EMS uses is MONA: Morphine or fentanyl for analgesia and to ease anxiety, which lowers sympathetic stimulation and decreases oxygen demand on the heart. Oxygen is given if the patient is hypoxic or in respiratory distress to ensure adequate oxygenation; it isn’t routinely given to all MI patients if they’re not short of breath or hypoxic. Nitroglycerin dilates vessels, which reduces preload and can improve coronary perfusion, provided blood pressure is adequate and there are no contraindications. Aspirin should be given to inhibit platelet aggregation, usually a chewable 162–325 mg dose, to help prevent further clot formation and improve outcomes. While this bundle helps stabilize the patient and buys time, rapid reperfusion therapy (such as PCI or thrombolytics) is the definitive treatment when indicated. Antibiotics and steroids don’t address the underlying problem in an acute MI, and CPR is reserved for patients who have collapsed or become pulseless, not for a patient who is awake with chest pain.

Managing a patient with an MI focuses on relieving pain, reducing myocardial oxygen demand, improving oxygen delivery, and starting antithrombotic therapy to limit heart muscle damage. The most practical initial approach EMS uses is MONA: Morphine or fentanyl for analgesia and to ease anxiety, which lowers sympathetic stimulation and decreases oxygen demand on the heart. Oxygen is given if the patient is hypoxic or in respiratory distress to ensure adequate oxygenation; it isn’t routinely given to all MI patients if they’re not short of breath or hypoxic. Nitroglycerin dilates vessels, which reduces preload and can improve coronary perfusion, provided blood pressure is adequate and there are no contraindications. Aspirin should be given to inhibit platelet aggregation, usually a chewable 162–325 mg dose, to help prevent further clot formation and improve outcomes. While this bundle helps stabilize the patient and buys time, rapid reperfusion therapy (such as PCI or thrombolytics) is the definitive treatment when indicated.

Antibiotics and steroids don’t address the underlying problem in an acute MI, and CPR is reserved for patients who have collapsed or become pulseless, not for a patient who is awake with chest pain.

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