Good morning sports fans!
You are dispatched to the residence of a 70 year old male, complaining of “shortness of breath”.
You pull up to a well kept home, and are met at the front door by the patient’s wife. She tells you that her husband came home from the hospital yesterday after cosmetic eye surgery.
You are led into the kitchen, and find your patient sitting in a chair at the kitchen table. There is an eye patch over his right eye. He appears to be in moderate respiratory distress. His color is ok, but you note he can only speak in short sentences.
He tells you that he was fine until this morning when he suffered a sudden onset of shortness of breath. His wife describes it as “wheezing”. You ask about any Asthma/COPD history, and he says he has none. He also denies any cardiac history. He tells you he also had bouts of “coughing up phlegm”, and felt “very weak”. As the day went on, his breathing worsened, so EMS was called.
You listen to his lungs and note basilar crackles. His history is significant for hypertension, repaired AAA, and skin cancer.
- Pulse: 116 and weak
- BP: 102/70 (patient states his systolic is normally in the 120-130 range)
- RR: 24 and labored
- SpO2: 92% on room air, and 97% on O2
- Skin: unremarkable
Here is his rhythm strip:
and 12 Lead ECG:
What could be wrong with your patient?
How do you want to treat him, and where do you want to take him?
The nearest hospital is the local hospital 20 minutes away, and the nearest cardiac center is 50 minutes away.
Let’s hear it!