Age, circumstance, and anything else I feel like has been changed.
This unit was dispatched to a 76yo M C/C SOB x2 days. Pt found seated in chair, w/ patent airway, no obvious respiratory distress, and no apparent life threatening airway. Pt states concern for pneumonia. Pt denies CP. Rhonchi bilateral lower lobes. HR 62, BP 128/70, RR 18, SaO2 97% r/a. Placed on O2 @ 2lpm via NC. SOB gradual w/o pain, worse with exertion, better with rest, "can't catch breath." Pt has no PMD, denies any prior PMD visits, no meds, NKDA. Pt seated fowlers on stretcher, seatbelts secured, taken via stretcher to ambulance. 3-lead monitor shows sinus brady, frequent PVCs, ST elev II/III. 12L ECG shows 2mm ST elev II/III/aVF w/ reciprocal changes I/aVL, ST depression V2-V5. Pt vital signs unchanged, denies CP. Feels "better" w/ O2. 4x 81mg ASA PO. Code STEMI alert given to receiving hospital, no questions. Care transferred to Cath Lab, written and verbal report given to receiving nurse.
We got to watch the cath lab at work:
- RCA: right marginal artery occlusion
- LAD: diagonal artery occlusion
- CX: complete circumflex occlusion
No stents placed, scheduled for CABG.
