Advanced Cardiovascular Life Support (ACLS) Practice Exam

A postoperative patient in the ICU reports new chest pain. What actions should take priority?

1. Administer pain medication

2. Obtain a 12-lead ECG and administer aspirin if not contraindicated

3. Call for immediate physician assistance

4. Reassess vital signs

The correct answer is: Obtain a 12-lead ECG and administer aspirin if not contraindicated

In the context of a postoperative patient in the ICU presenting with new chest pain, prioritizing the acquisition of a 12-lead ECG followed by the administration of aspirin—if there are no contraindications—is critical for several reasons. First, new chest pain in a postoperative patient could indicate serious complications, such as myocardial ischemia or other cardiac events. Performing a 12-lead ECG is vital as it provides immediate information about the cardiac electrical activity and can help identify conditions like ST elevation myocardial infarction (STEMI) or other abnormalities that require urgent intervention. Additionally, administering aspirin is an essential step in the management of suspected acute coronary syndrome (ACS), as it plays a significant role in inhibiting platelet aggregation, thereby reducing the risk of further thrombus formation in the coronary arteries. This is particularly important in the context of potential cardiac complications. While administration of pain medication, calling for immediate physician assistance, and reassessing vital signs are also important components of patient care, they should follow the immediate assessment of the patient's cardiac status and the initiation of antiplatelet therapy. Pain relief can be provided once acute life-threatening conditions have been ruled out or stabilized, and vital signs should be continuously monitored but are secondary to obtaining a diagnostic ECG