Share Your Story
Submitted by Paramedic Chris C. – N. Carolina:
My unit was dispatched to a local physicians office for an elderly female patient experiencing chest pain. Upon arrival, found the patient upright on an exam table, clammy, diaphoretic, in obvious distress. The physician was in the room, with several nurses.
The physician handed over a 12 lead, which showed an inferior MI with reciprocal changes. The physician advised that the patient was to go to the local ED for evaluation for chest pain. I questioned the physician on going to the PCI center, and was told he has already spoken to the local ED doc, and that the patient was expected at the local ED.
Patient was transported to the local ED, hike receiving treatment per local protocols. IV, O2, ASA, NTG, cardiac monitoring.
Arrival to the local ED was organized. Patient was placed in a trauma bay, with staff doing various aspects of care. Thrombolytics were ordered, however delayed. Aeromedical Evac was called for, and approximately 15 minutes later we were advised of their launching. The lytics were given about 30 minutes after patients arrival to local ED, aeromedical Evac took place about 50 minutes after arrival, with a 13 minute flight to PCI center.
Keep in mind we could have made it to the PCI center in 25 minutes from where we picked up the patient.
Submitted by Paramedic Chris C. – N. Carolina:
It was 0430, my unit was distpatched to a private residence reference an elderly male with nausea. Keep in mind my system uses EMD, so the complaint we were dispatched to was an Alpha level call, routine trafffic. So off we go no lights or sirens, about 16 miles across the county. Upon arriving to the residence, we find the mans wife at the front door, saying she didnt know what else to do. We got to the patient, found him sitting upright in a chair in the living room, conscious and alert. The patient had a look of uneasiness about him, appeared to be anxious. His skin was clammy, diaphoretic. He states he woke up at 0400 suddenly with severe nausea, no vomitting.
So we begin our assessment process. We discover that he had a Hx of NIDDM, HTN, previous MI, approximately 12 years prior. The patient states he has felt fine up till 0400. Patient denies any pain or discomfort, repeating he is only experiencing some nausea. No weakness, nothing. Vital signs initially are 112/74, HR 76, RR 20. BGL was 110.
Patient states he wants to go to the ED, so we assist him to the truck for transport. As we are getting him on the stretcher, he states that he felt a little pressure when he first woke up. So I instantly place the patient on the monitor, 4 lead shows an anomoly with the rythym. We run a 12 lead, which sjows an inferior wall MI with reciprocal changes. I ask the patient again if he is hurting anywhere or has any discomfort at all, he says no. So we start treating rapidly. The local FD first responders squad had just been dispatched to assist another medic unit, I contacted dispatch on the radio and requestred on of the first responders divert to my location to drive. WE also called for the local air evac helo to meet us at the helipad at the local ED.
Ten minutes after recognition of the STEMI, The patient is recieving TnKase at the ED. Air medical is on the ground, and in the ED prepping the patient for transport. Heparin drip is flowing, TnKase is on board, and the patient is getting loaded in the helo within 10 minutes of arrival to the ED. All in all it was a very smooth transition and continuum of care.
We go from a routine nausea call with a 70-odd year old man, to a full blown STEMI call. EMD doesnt always work as it should, in this case, as it turns out, as a result of lack of information from the caller.
Still waiting to hear on the outcome of the patient, i should find out in the next few days.
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