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A 64-year-old woman calls for an ambulance following four hours of chest pain. The paramedic arrives and performs an ECG.
What is the diagnosis?
On examination, she has a pulse of 100 per minute, BP = 160/90, SaO2 = 93% on air, and RR of 22 breaths per minute. She has no contra-indication to thrombolysis. The nearest hospital, which also happens to have PCI facilities, is about 20 minutes away.
Rank the following reperfusion options for this lady in order, from most appropriate (1st) to least appropriate (4th):
Primary PCI
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Pre-hospital thrombolysis
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In-hospital thrombolysis
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Facilitated PCI
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