Author: Phaedra Rampersad / Editor: Sarah Edwards / Codes: SLO3, VC2 / Published: 11/11/2024
A man in his 60’s presents to the Emergency Department (ED) with a syncopal episode. The patient has a background history of chronic kidney disease and hypertension. He attended his regular dialysis and on returning home his family heard a crash and was found on the floor.
He was brought in unresponsive GCS3/15 and then gradually regained consciousness without any intervention. His vital signs are as follows:
- BP: 155/95
- Pulse: 85 bpm
- RR: 18 brpm
- SpO2: 99%
- BM: 6.0
He was put on high flow oxygen and then assessed using the ABCDE approach. An ECG was taken and is shown below:

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Question 1 of 3
1. Question
Which of the following is the least likely diagnosis?
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You are in a rural setting and the nearest PPCI centre is 2 hours away, what is the next appropriate step that can be done prior to transfer?
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POCUS was done and it showed the following. What is seen from the images provided?
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