59 year old male: chest pressure

It’s a hot summer night in the suburbs, most of which you’ve spent on standby for a local baseball game. After clearing up you’re put on a chest pain call a few blocks from your quarters. The local volunteer fire department has a squad on scene which is advising you to, “continue on emergency.” Upon your arrival you find the patient seated on the porch, on O2 via a non-rebreather, in moderate respiratory distress. The volunteer EMT relays that the patient, a 59 year old male, is having 10 of 10 chest pressure which started yesterday. He’s administered 324 mg of aspirin and withheld nitroglycerin because of the patient’s blood pressure. You’re handed a quick trip sheet as you take over patient care. Pulse: 50, weak at the radials BP: 80/40 RR: 24, labored, lungs clear and equal bilaterally SpO2: 90% on room air, 94% on 15 L/min via NRB Your partner starts putting on the electrodes for a 12-Lead while you get a quick history. PMHx: hypertension, hypercholesterolemia, GERD Medications: lisinopril, lipitor, omeprazole, “vitamins” Allergies: penicillin, sulfa drugs, levitra Last ins/outs: normal dinner The patient appears acutely unwell, ashen gray, and diaphoretic. He states the pain is, “pretty constant now,” and that he feels it in, “my shoulder blades and running down my spine”. Your partner hands you the initial 12-Lead: The EMT helps you and your partner place the patient on your stretch...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: ems-topics patient-management 12-Lead ECG case study Christopher Watford EMS 12-Lead Paramedic Source Type: research