Chest Pain after flight

[ibemt31]

after considering what you all have said, i realize PE could be a real possibility, now that i think about it. also, whoever was implying that this pt was potentially serious, just know she was treated as such. high flow o2, rapid transport and request for als personnel. just wanted to see what everyone else thought. it is not our job to diagnose, but to treat for potentials and treat what we see. and btw it IS retarded for NJ bls not to be able to check BGL. if i suspect hypoglycemia i can administer oral glucose but i cant verify hypoglycemia with a procedure so simple that patients and their families are trained to do it. that is retarded.

[brentoli]

and btw it IS retarded for NJ bls not to be able to check BGL. if i suspect hypoglycemia i can administer oral glucose but i cant verify hypoglycemia with a procedure so simple that patients and their families are trained to do it. that is retarded.

How would this change your treatment from the BLS perspective? What would you do diffrently with the BGL known?

[ibemt31]

ummm if you read my post properly, i dont recall mentioning anything about bgl specific to this call, i was stating that it is in general retarded. please read post carefully before commenting in the future. i am being attacked because i answer everything everyone asks about the scenario and then someone else chimes in and asks how it applies to the call, i dont know how it does ask the person who asked what her bgl was.

[brentoli]

Sorry, was speaking in general. How would you as a BLS provider be able to change treatment with what you have available by knowing BGL. I'm not attacking you. I should have asked in a diffrent thread which I will do after a search.

[mediccjh]

FYI, I AM A BLS PROVIDER THEREFORE THIS IS FROM A BLS PERSPECTIVE....you are dispatched for a chest pain on an airliner. upon your arrival yo find a 45 y/o female seated in airplane seat in no visible distress c/o chest pain. pain is currently minor, 2 or 3 out of ten. Patient states she developed severe chest pain during the flight three seperate times. pain is described first as a pressure but later described as a sharp pain/pressure, originating from area of zyphiod process, laterally along the thorax, and radiating up into the chest. when asked if pain was worsened by inspiration pt states she couldnt take a deep breath during episode. upon palpation of chest, pain was not worsened, it was not reproducible. three seperate episodes occurred, and family states pt "passed out" after each of three episodes, a few minutes after pain became severe.pt hx of hypotension, asthma and unknown stomach issues, claustrophobia and gallbladder removal. pt did not believe symptoms were related to claustrophobia, and has flown before without a problem. v/s hr 64 rr 16 b/p 100/70. pt states normal bp is 80 sys. additional sets of v/s were similar, and as we were pulling into the er the pressure was 80/35, which pt states is about normal. take it from here, als and bls providers please.

btw, flight was about a 4 hour flight

First off, use proper grammar. I know Newark public schools stink, and English is not the first language in the Ironbound section, but they do teach that. Also, try using sentences. My eyes are bleeding from trying to read that.

If I were on MIC-5 that shift (I know what ib31 stands for ), Remove from plane, evaluate somewhere where I can do my 12-lead with privacy.

What medications are the patient on? What was their build? If their pressure is normally 80/systolic, they are probably an athlete with a small build. Depending on the elevation of the flight, a small pneumothorax is possible. What side of the chest did the pain radiate to-left or right? You did not mention this.

Keep them on O2, and run them nice and easy to the U.

[CBEMT]

How would this change your treatment from the BLS perspective? What would you do differently with the BGL known?

I would think that being able to rule out hypoglycemia in a suspected CVA patient would be helpful pre-hospital, particularly if ALS is unavailable or too far out (by way of example, I know not germane to this scenario).

[ibemt31]

Mediccjh, I hope this grammar is easier on your eyes than the grammar in my previous post. My previous post was written while I was half asleep. I do appreciate pointing our my lack of proper grammar, however it was due to inattention and exhaustion and not ignorance. 8)

I applaud you, you figured my username out. lol I am not trying to hide that I am indeed from Ironbound. I appreciate the input that you have provided. I am seeking feedback, which is why I posted this case on here. I am here to learn, to become better at what I do. The patient in question was a female in her forties. I would not classify her as athletic, but she was small in stature. She was on singulair for asthma, and a medication that I cannot recall that was prescribed due to gastrointestinal problems related to Gallbladder removal. The pain seemed to originate at the level of the zyphoid process in a "band" of sorts, across the thorax. This pain radiated directly superiorly, moving pretty much across the entire chest, not necessarily to one side or the other. As you advised, this patient was placed on o2 and transported nice and easy with ALS to the hospital. Perhaps it was a small Pneumo, as you have suggested. Perhaps it was something else. Thank you for your input, like I said, I am here to learn, for that is one thing we never should stop doing.

[mediccjh]

Mediccjh, I hope this grammar is easier on your eyes than the grammar in my previous post. My previous post was written while I was half asleep. I do appreciate pointing our my lack of proper grammar, however it was due to inattention and exhaustion and not ignorance. 8)

I applaud you, you figured my username out. lol I am not trying to hide that I am indeed from Ironbound. I appreciate the input that you have provided. I am seeking feedback, which is why I posted this case on here. I am here to learn, to become better at what I do. The patient in question was a female in her forties. I would not classify her as athletic, but she was small in stature. She was on singulair for asthma, and a medication that I cannot recall that was prescribed due to gastrointestinal problems related to Gallbladder removal. The pain seemed to originate at the level of the zyphoid process in a "band" of sorts, across the thorax. This pain radiated directly superiorly, moving pretty much across the entire chest, not necessarily to one side or the other. As you advised, this patient was placed on o2 and transported nice and easy with ALS to the hospital. Perhaps it was a small Pneumo, as you have suggested. Perhaps it was something else. Thank you for your input, like I said, I am here to learn, for that is one thing we never should stop doing.

Yes, this post was easier on my eyes. I was ball-busting about the Ironbound, nothing meant to be harmful. Come here for feedback, and don't be afraid to question us evil medics.....just do it after the job. And don't call my bus a rig. :twisted:

[chbare]

...and a medication that I cannot recall that was prescribed due to gastrointestinal problems related to Gallbladder removal...

I wonder if she needed an ERCP?

Take care,

chbare.

[medicmike247]

I'd consider PE, treat with high flow O2, monitor, IV, and rapid transport.