Scenario Name: Mega Code (Cardiac Arrest)

Learning Outcomes:

1. Recall the anatomy and physiology of the heart.

2. Identify the signs and symptoms of acute myocardial infarction.
3. Recognize the signs of impending collapse.
4. Assist in accurate recording & reporting of incident report.
5. Discuss the role of the enrolled nurse in resuscitation:
• Administration of oxygen
• Insertion of oropharyngeal airway
• Assist with endotracheal intubation
• Assist with external defibrillation
• Prepare patient for transfer to ICU/HD

Scenario:

Mr Rajah, aged 58-year-old delivery driver, BMI of 30, married with 2 children and the sole breadwinner for his family. He has past medical
history of hypertension on Atenolol 50mg OM and hyperlipidaemia on Simvastatin 20mg ON. Mr Rajah often forget to take his medications
because of his busy work schedule.

Mr Rajah is admitted to your ward for an episode of chest pain early this morning. Blood investigations were done in A&E and his ECG shows ST
elevation.
 On arrival Vital Signs Investigations done in A&E
Temperature: 36.9°C ECG evident of ST elevation
Pulse: 100bpm, regular/strong CXR Clear
Respiration: 20 bpm, FBC NAD
regular/normal U/E Na-120 [135-145mEq/L], K- 3.0 [3.5-
Blood pressure: 140/75 mmHg 5.2mmol/L]
Cardiac Enzymes Troponin T elevated
SpO2: 96% Room Air
Pain Score: 6/10, Crushing
Mental State: Conscious and alert

Medications
PO Paracetamol 1g QDS/PRN
IV Normal Saline 0.9% 1L over 24hr
S/L GTN 600mcg PRN