So, I was called earlier to transport a 75 year old female to the CCU 150 miles away for investigation of Acute Coronary Syndrome.
History is that she had sudden onset back pain between shoulder blades 24 hours prior. Throbbing in nature like she's being repeatedly stabbed but then resolved a short time later. She went to the doc who assessed her and sent her back home. Today at noon she had the same pain, 10/10 radiating to jaw and left arm. She went to the ED and their assesment included a Right arm BP 157/82 Left arm BP 132/76. Heart rate NSR at 60, Sats 95% on 3l, Lungs clear and equal, abd is soft and nontender. 12 lead shows inverted T waves in V1 - V3, 1mm S-T depression. Lab values, including trops are normal. Sorry, no picture of the ECG. Chest X-ray was unremarkable. No other diagnostic imaging was available.
Upon my arrival she was on a heparin infusion at 1000 units per hour. Stat meds include Nitro, ASA, Enoxiparin, and Heparin. PmHx is Hypertension and diet controlled diabetes. as well as a family cardiac history. Our doc consulted with the cardiologist who decided the treatment plan
I assessed the client who was now pain free. BP was similar to that noted above. Pulses were equal at wrists and feet and we began transport...but I have this nagging feeling.