Here’s an interesting case submitted by my friend Lt./NREMT-P Chris B. This is all the information I have, so I won’t be able to answer any questions about the history, clinical presentation, or physical exam.
You are dispatched to a 63 year old male complaining of chest pain.
On arrival you find the patient lying supine in bed, alert and oriented to person, place, time and event. His general appearance is poor. He is pale, but not diaphoretic. Skin temp is normal. His chest pain is substernal 6/10 and non-radiating.
RR: 12 non-labored
SpO2: 81 RA
Breath sounds: clear
Past medical history
CABGx4 approx 6 years ago
End stage renal disease
The cardiac monitor is attached and shows this heart rhythm:
What do you think is going on?
What is your treatment plan?