77 year old female CC: Abdominal Pain

It's a quiet Sunday afternoon when you're dispatched to a residence for a 77 year old female complaining of abdominal pain. Your dispatch notes indicates she was at the ED the day prior. Upon your arrival, you're met on the porch by the patient's son who directs you inside. Your patient is sitting in a recliner, with mild respiratory distress, clutching her abdomen. Her skin appears a bit moist, and is warm when you touch her arm to feel for a radial pulse. When you ask her what is going on, she simply replies, "my belly won't stop hurting." Your partner makes quick work of her vitals while you get the run down on her history. Signs/symptoms: 7 of 10 abdominal pain going to her back, belching, intermittent vomiting Alergies: Codeine Medications: lisinopril, metoprolol, furosemide, potassium chloride, magnesium oxide, lipitor, albuterol, vitamin supplements, metformin, iron PMHx: renal failure with dialysis (shunt Rt arm), hypertension, hypercholesterolemia, type II diabetes, pacemaker, asthma Last ins/outs: vomiting x 3 today, did not do dialysis on Friday due to nausea/vomiting Events: progressive worsening of pain and nausea Your general impression of the patient is she just looks unwell. Your partner relays her vitals. Pulse: 80 bpm, irregular BP: 210/100 RR: 24, wheezes SpO2: 94% on room air T: 99.1 F (37.3 C) BGL: 194 mg/dL (10.7 mmol/L) Her son asks that you take her to the smaller, local hospital so, "she does not have to wait as ...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: ems-topics patient-management 12-Lead ECG case study Christopher Watford Paramedic Prehospital 12-Lead ECG blog Source Type: research