INems

Thank you Jake. I really do appreciate your time in looking at this for me. I don't feel like anyone was bustin my balls or anything. I'm just not that knowledgeable as of yet in the ways of the EMTB. The whole 12-lead is what is throwing me. Hence why I want to get ALS taken soon. At least that way I will have the ability to learn to read and accurately interpret the 12-lead. I have the ability to transmit to the hospital, but the docs there are of the mind that if it wasn't done at the facility then it's not accurate at all. I can work up a 12-lead, but it's getting the proper information out of the docs that is the real time killer. Couldn't say any of this for the test because it is "technically" outside the scope of practice here. I will keep the questions coming. Thanks for the help.

Thank you gentlemen for your honest opinion here. I am a Basic and I do plan on taking ALS and TacMed at the first available opportunity I have. Having heard your opinions, I do agree with the impending code. The first set was taken and then MC was called. The second set was taken approx. 5 minutes later due to the signs of hypoxia. The test was based on 2 EMT-Bs on the bus (which means no IV's or 12-leads, which I wish they would go ahead and cover during our course and include it in our scope of practice which would stop a lot of problems like this, but unfortunately, that is never likely to happen in Indiana anytime soon) with one first-responder already at the scene (in this case, a dept. head). The whole scenario was kinda weird in the way it was laid out to me. The vitals is what truly tripped me up. I guess that if I had more "training" on this type of scenario than this would have made more sense to me. Thank you for responding.

You were just called out to the workplace of a female in her late 40's that is unresponsive. Below is what I said and did. What would you have done differently and why? BSI. Scene safe. Only patient. NOI- unresponsive. C-spine possible. No further assistance at this time. Upon arrival- Patient is A/O x3. Complains of chest pain with radiating sensations down her left arm and up into her left jaw. Transport is Priority at this time. Airway is patent. Breath sounds are clear bilaterally in the lungs. Circulatory is good. No bleeding or mass bruising indicating a closed hemorrhage. Complaint of chest pain No allergies Meds include: Aspirin regimen, nitro, Plavix, and another med for blood pressure. Pertinent History: Had a cabbage done 10 yrs prior. No further history given. Last oral intake: about an hour ago. Event: shoveling corn at the grainery. Onset: about 4 hrs. ago. Thought it was just heartburn due to spicy foods consumed. Provocation: Nothing is working. Took 1 nitro about 15 min. ago. Quality: Crushing and squeezing pain. Radiating Pain: Down left arm and up into left jaw. Severity: on the 1-10 scale Patient rates at a 8 or 9. Time: started having arm and jaw pain about 2 hours ago. Ignored the pain due to already mounting medical bills. Husband also has history of heart problems. Focused physical: Lungs are clear bilaterally. Pupils are PEARRL. Vital signs: BP 160/92, HR 120, pulse is heavy and uneven. Skin is cooler and drier than normal. Breathing is shallow and slow. O2 is by non-rebreather at 15 lpm. Start ALS for Cardiac complications. Prepare for Trans. Contact MC for nitro and aspirin. 1 Nitro to be given and no aspirin at this time. If no effect than 1 more can be given in 10 mins. Gave one nitro after verifications were met. Second Vital sets: pulse is uneven and thin. BP 80/50, HR 150, skin is starting to show signs of hypoxia. Breathing is labored and shallow. Reconsider as a Priority Rapid Transport. Treat for shock and call ahead to hospital for response team. Keep re-evaluating all vitals and interventions.