47 year old male: Holiday Indigestion

Thanks go to a long time reader Nicholas Eisele for this holiday case! As always, details have been changed to protect patient privacy. It is a blustery Christmas morning when you and your partner are dispatched for a 47 year old male with chest pain. Firefighters are already on scene obtaining a history and vitals when you arrive. You check in with the officer in charge, a paramedic, and he reports that the patient has been having a "burning sensation" in the middle of his chest, going to his back. As it is Christmas morning and the patient's family is opening presents, the officer also relays the patient, "is likely going to refuse." He also relays that they witheld ASA due to the patient's "indigestion." One of the firefighters gives your partner the patient's vitals: HR: 70 bpm, regular at the radials BP: 144/96 RR: 18, unlabored, in no apparent distress SpO2: 95% ECG: "normal sinus, nothing out of the ordinary" (no 12-Lead was captured) You perform a quick patient assessment prior to making any decisions: Onset: 21:00 the prior evening Provocation/Palliation: pain went away over night with sleep, came back after breakfast; nothing makes it better now Quality: "burning" Radiation: "straight thru to my back" Severity: 7 of 10 Timing: constant burning A focused history reveals no prior cardiac problems and that the patient takes no medications and has no allergies. Given the patient's symptoms a...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: ems-topics patient-management 12-Lead ECG case study Christopher Watford data quality EMS 12-Lead Paramedic Source Type: research