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FireEMT2009

80ish year old patient trouble breathing

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Hm, I think you're right, Dwayne, I was a little hasty there. Let's reassess first, and increase that O2 to 15 LPM by NRB if we haven't already.

I`m with Dwayne reffering to the Nitro. Apart from the initial two tabs I wouldn`t give anymore (at least with a transport time of 10 minutes and no new increasing pain after an initial nitro-related relief).

Addittionally I wouldn`t increase the O2. Since my biggest guess would be a cardiac event. The Pt. has a SpO2 of 98%. That`s enough. The ERC 2010 Guidelines (as well as the AHA, I guess) recommend a SpO2 between 94-98% in ACS. According to the Guidelines, hypoxia is to avoid - as well as hyperoxaemia, since it causes intracellular stress.

Instead of fentanyl, morphine would be my choice.

Aside from that - en route the hospital.

Greetings, Marius

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Didn't someone post a study/studies in the last year or two that, opposed to showing any type of benefit with Morphine, that there was like, a 50% increase in mortality with AME/MI?

I can't remember for sure...but I think so. I can't seem to find it now though...

Dwayne

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Didn't someone post a study/studies in the last year or two that, opposed to showing any type of benefit with Morphine, that there was like, a 50% increase in mortality with AME/MI?

I can't remember for sure...but I think so. I can't seem to find it now though...

Dwayne

Really?:confused:

Never heard of that. Here, Morphine is still the main analgetic in AMI.

50% in itself would seem like a huge figure - if that would be the case, I`m sure that study would have surely been recognized by a wider audience? :blink:

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