chest pain bad, nitrates good

[Arctickat]

Kiwi, read the two words he typed after "Rapid Transport" and in reference to Kaisu's post, it is absolutely astounding to me how some people are just incapable of looking at the big picture. I had to stop a doc one day from cardioverting a tachycardic patient who was hypotensive with a decreased LOC, oh, and he was a hypovolemic trauma patient.

Edited December 17, 2012 by Arctickat

[DFIB]

What is this "big picture" you speak of?

[Kaisu]

Seeing the big picture means you are a clinician and not a technician. It means gathering all the pieces (signs and symptoms) and coming up with a diagnosis. In Arizona, medics are forbidden to use the word diagnosis. The reasoning is that we are too under-educated to make diagnosis and instead must state the protocol we are utilizing. This is a requirement on the PCR. We state our Impression.

A medic trained in another system where the emphasis is on underlying pathophysiology and looks for the "big picture" is looked on with suspician, labeled a "hot dog", is not fit to precept others because he/she will lead the poor lambs astray, beyond the allmighty protocol into dangerous territory.

I have to laugh. It's preferable to crying.

[DFIB]

Thank you Kaisu, I was being a little facetious, but I like your definition.

[Bieber]

I share your frustration and I agree with you wholeheartedly. We should not be treating patients with chest pain with aspirin and nitro; rather, we need to get it into our heads that that is the treatment for patients complaining of ACS.

Not all chest pain is ACS, and not all ACS includes chest pain.

Kaisu, that's pretty messed up. But the only way to combat the anti-clinician mentality is to make that kind of mindset unacceptable among ourselves.

[Kiwiology]

We should not be treating patients with chest pain with aspirin and nitro; rather, we need to get it into our heads that that is the treatment for patients complaining of ACS.

Not all chest pain is ACS, and not all ACS includes chest pain.

Please tell me that y'all do look for some objective evidence of myocardial ischaemia before treating patients for it? If not then teach time you do, one of my brain cells, some starving beafran child and a cute small animal dies a violent, gut wrenching, gutteral death because of the intense stupidity and massively extreme fail involved.

Merry Christmas Jeedadeech from the World Vision ads of the 90s, better hope Nana don't get no chest pain tonight!

[Sequel]

Sounds like some cardizem could've fixed the problem and gotten rid of the associated chest pain. >.>

[RuralKSEMS]

In our service, we are not allowed to give nitro unless we have obtained a 15 lead per medical direction. According to our AEMT instructor (service director as well); there are studies that have proven that one instance of hypotensive blood pressure greatly increases the risk of mortality in an MI.