Jeep_911 Posted June 17, 2006 Share Posted June 17, 2006 so....this is another one of these calls that makes me wonder. Had it about 8 days ago....actually it was a really strange call for me but here is how it goes. Good call. First party caller from a campground. The only info the dispatcher is able to get is caller feeling unwell and requests an ambulance then before they are able to get more info the other end of the phone goes really quiet. I request RCMP as well...not really sure whats going on and I dont want to be caught off guard. We arrive on scene and find the campground spot where we find our patient, a 28 yo male sitting on the passenger side of an old motor home, half of patient's clothing appears wet. He doesnt look well, a little diaphoretic but doesnt appear in obvious distress. There isnt anyone to get history from. My partner start talking to our patient as I'm getting vitals. Chief Complaint: Feeling unwell, some dizziness earlier, 6/10 chest pain constant, no radiation, does not get worst on inhalation/movement, no pain in face/neck/arm. No trauma Hx. No other problems. PMHx: Nothing pertinent, some cardiac problems but patient unsure what they were but is aware all the test that were done were normal. No family cardiac history. No unusual events in pt's Hx. No meds or recent health concerns. Breathing:20 Pulse:160 rapid/weak Skin color:pale,cool,moist BP: 132/90 SPO2:98% ECG (partner does 12 lead in ambo): Sinus tach. (patient states not seeing anything other than tachycardia) Tx:I believe vagal maneuvers were attempted but produced nothing. O2 via NC@ 4lpm. 18g needle started in left AC. No meds were given on route to hospital. En route to hospital pulse did come down in the 130's but as soon as patient would move position pulse would go back up and remain in the 160's before going back down again. *patient did state chest discomfort going away approx 5-6 mins after O2 administration. No other changes in vitals. What do you think was going on? (what other info would you like to have I may have forgotten to put up?) Link to comment Share on other sites More sharing options...
Jeep_911 Posted June 17, 2006 Author Share Posted June 17, 2006 sorry forgot to say where the pain was. It was in the left mid axillary area Link to comment Share on other sites More sharing options...
itku2er Posted June 17, 2006 Share Posted June 17, 2006 were any meds given at all to lower his heartrate.....was there any evidence of drugs or alcohol use?.....could he have been bitten by any insect or snake.....or have any other possible allergies?....what was the temp outside.......what were the events that lead up to his chest pains what was he doing Link to comment Share on other sites More sharing options...
Jeep_911 Posted June 17, 2006 Author Share Posted June 17, 2006 No there was no obvious use of alcohol or drugs. Insects....thats a good point, but I dont know of anyone in our area who has had a call for bugs...but I guess you never know. Very intelligent thought....He had no known allergies and the temp outside was very pleasant....t-shirt weather. He was outside hanging some clothes when it started and he said he suddenly started to fill dizzy. He said he wasnt sure if he fainted (made me wonder because he was by himself and half his clothing was wet, it was wet outside form recent rain....thinking he might have....) Link to comment Share on other sites More sharing options...
rat115 Posted June 17, 2006 Share Posted June 17, 2006 When and what were his last oral intake? Link to comment Share on other sites More sharing options...
Jeep_911 Posted June 17, 2006 Author Share Posted June 17, 2006 Chicken and rice or something like that earlier that afternoon.....maybe 5-6 hours ish before we got there Link to comment Share on other sites More sharing options...
MedicMal Posted June 18, 2006 Share Posted June 18, 2006 meds, allergies? Has he had chest pain before (same, different?) when he had his other cardiac problems? Has he had a racing heart rate before? Link to comment Share on other sites More sharing options...
AZCEP Posted June 18, 2006 Share Posted June 18, 2006 It would be nice to see the strip, but it sounds like PSVT. Rapid onset and termination. Symptoms during episode with some resolution when the rate slows down. Mid-late 20's is a pretty common time for this to be found. The discomfort he described sounds like an ischemic event due to the rate. The sick just keep getting younger and younger. Link to comment Share on other sites More sharing options...
ERDoc Posted June 18, 2006 Share Posted June 18, 2006 I'm having trouble believing that at 160 the rhythm was sinus tach. If I had to be I would either say it was RAF or SVT, either of which could explain the possible chest discomfort and syncope. Link to comment Share on other sites More sharing options...
Jeep_911 Posted June 18, 2006 Author Share Posted June 18, 2006 No meds, I think he did say that he has had that happen before and it was a very similar experience as the one we went for...and I believe it was an SVT on the monitor Link to comment Share on other sites More sharing options...
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