Here’s another interesting case submitted by Geoff Dayne.
79 y/o male c/o non-provoked SOB without CP.
Patient was found sitting upright, tripodding, 1 word dyspnea.
Lung sounds: extremely decreased tidal volume. EMS crew was unable to tell if there was rales or wheezing.
Past medical history: HTN, dyslipidemia, CHF, pacemaker (recently implanted within a week or so), diabetes, emphysema.
Drug allergies: Sulfa
Current meds: Glipizide, Omerprazole, Hydralizine, Lovastatin, Lasix, Albuterol
Pulse: 134 Strong/Irregular
SpO2: 84 on RA
They treated w/ O2 and put him on the patient’s home BiPAP and transported.
A 12-lead ECG was captured.
And a rhythm strip.
I think this case is an excellent example of the real-life difficulties paramedics face in the field when it comes to the triage of possible ACS patients.
What would you do next as the treating paramedic?
Found on the Lifenet Receiving Station (LBBB with concordant ST-depression in leads V3 and V4)
62 year old male CC: Chest pain (LBBB with ST-elevation > 0.2 the QRS complex)
58 year old female CC: Chest pain – Conclusion (meets all 3 of Sgarbossa’s criteria)