mshow00 Posted August 25, 2008 Share Posted August 25, 2008 Did he take a blow to the chest? I am kinda re thinking this.... maybe cardiac tamponade what does his heart sound like? Link to comment Share on other sites More sharing options...
ERDoc Posted August 25, 2008 Author Share Posted August 25, 2008 Heart sounds are good. The pain starts getting better with nitro. He gets his aspirin. His BP has come down to 120/70 but his heart rate is 139. You are still a good 20 minutes from the hospital. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 25, 2008 Share Posted August 25, 2008 what is the result of the inclusion and exclusion criteria for thrombos? or can we cath him in the ambulance? Link to comment Share on other sites More sharing options...
Kiwiology Posted August 25, 2008 Share Posted August 25, 2008 Our EMS thrombolysis indications are: - 75 years of age or younger and, - A cardiac clinical history and discomfort for less than 12 hours and, - No history of recent trauma, injuries due to falls, or extended CPR less than 2 weeks ago and, - No CVA or head injury history within the last 6 months and, - No major surgery within the last 2 months and, - No GI bleed within the last 2 months and, - No peptic ulcer disease within last 3 months and, - Not be taking Warfarin and, - No uncontrolled hypertension greater than systolic of 200mmHg Assuming this guy check's out and because he has anterior ST elevation (5mm in V1, V2 and V3) I'm gonna get on my trusty radio and check in with the doc's at medical control about warming up the heparin and reteplase. Is he still throwing PVCs? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 25, 2008 Share Posted August 25, 2008 would the trauma of fighting with the policia be an exclusion though? Just askin!!!! Doc says we have a virtual pharmacy and ED in the ambulance, can we cath the guy is what I want to know Link to comment Share on other sites More sharing options...
paramedicmike Posted August 25, 2008 Share Posted August 25, 2008 Pulses in all extremities strong and equal, JVD, blood pressure difference between arms, hoarse voice? I like chbare's questioning. Do we have an answer to this yet? -be safe Link to comment Share on other sites More sharing options...
zzyzx Posted August 25, 2008 Share Posted August 25, 2008 I'm coming to this a little late...so far it sounds like a textbook MI. But of course I know ERDoc has something up his sleeve. Does he feel hot? Can we do a drug screen on our mobile ER? What does the chest Xray show? I'm worried about an aortic dissection. Link to comment Share on other sites More sharing options...
firedoc5 Posted August 25, 2008 Share Posted August 25, 2008 Was he tasered at any point, or sprayed? Maybe that's why he didn't fight back too hard. Narcotics or ETOH? Did he have a reason for running? If it was only for a traffic stop, he must of had a reason to run, unless he's one of those idiots. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 25, 2008 Share Posted August 25, 2008 is being a dumbass a exclusionary criteria? I still want to know if our mobile intensive care catheterization unit of the future (miccuotf) is functional and what the catheterization showed prior to and post opening of the vessel. Link to comment Share on other sites More sharing options...
zzyzx Posted August 25, 2008 Share Posted August 25, 2008 I said before that it's textbook MI, but now that I think about again, it's not. I would we worried about the following possibilities: 1) MI 2) PE 3) aortic aneurysm 4) drugs 5) cardiac contusion. Any pain on palpation? Broken ribs? Bruising? Link to comment Share on other sites More sharing options...
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