Responded to a 911 call for a middle age male approx 50 year | Figure 1
Incident Report
Responded to a 911 call for a middle age male approx 50 years old with chest pain at a gas station. Arrived on scene to find the pt sitting in the passenger side of a Jeep. The pt's respirations were regular and non-labored. Pt's skin was cool/diaphoretic. Pt had a palpable, regular, strong radial pulse. Pt stood and walked to the ambulance by choice. Pt reports a pain scale of 5/10 and sharp, it radiates to his left shoulder and arm. Pt transferred to the stretcher and was secured with straps and rails. A 12 lead EKG was obtained and showed elevation in leads 2, 3, and AVF. The 12 lead was transmitted to receiving hospital. A posterior EKG was obtained and showed minimal ST changes. Medic unit left the scene en route to St. Clare hospital. An 18 gauge IV was attempted in the right AC, blood was drawn but the IV would not flush. An 18 gauge IV was established in the left AC. Pt was given 4, 81 mg aspirin. Pt states that he is pain free. A phone report was called into the hospital. A 100ml fluid bolus of normal saline was started. Pt states the pain began about an hour ago while he was doing landscaping work; it lasted about 10 minutes and went away with rest. The pain started again while he was working, but has not gone away after resting. Nitroglycerine was withheld due to right-sided STEMI; lead 3 had greater elevation than lead 2, and short duration of transport to the hospital. Pt was unloaded by EMS x2. Pt then reported a return of his chest pain. Pt was transferred to bed via draw sheet method. An oral report was given to pt’s doctor, nurse, and STEMI team. Pt care was transferred. Pt was taken back to the cardiac cath lab, where a 99 percent blockage of the distal RCA was successfully stented. A blockage of the LAD was also noted but the cath lab chose not to intervene at this time.
Additional Case Information
- Patient History:
Allergy to Cipro
History: COPD, CVA, CAD
Medications: Clopidogrel, Pantoprazole, Acetaminophen, Ecotrin, Proventil