Hey sir my name is Shane. I am a paramedic and this is my partner Kimberly.
What seems to be the problem today?
My chest is really hurting.
Your chest is hurting? Do you mind if I take a seat?
No.
OK sounds good.
How long ago did this start?
Just about an hour ago.
About an hour OK.
Well why don't I go ahead and get some vitals on you. Is that OK with you?
uh huh
OK cool. Do you mind if I see your wrist?
OK awesome.
OK so you said it started about an hour ago.
Do you ever have anything like this happen before?
Back in 2010 I had a heart attack kind of like this but this is worse.
oh OK. and were you doing anything to like bring it on?
Were you trying to run a marathon or anything like that?
Just cleaning around the house so my girlfriend could come over.
OK. And what type of pain is it? Is it a bad pain or a sharp pain? or?
It's like a pressure, squeezing.
Pressure and squeezing OK. And at a scale of 1 to 10 what would you say it is?
I'd put it at seven.
About a seven OK alright. Sounds good.
Well we are going to go ahead and start these vitals here on you real quick.
We are going to get some lung sounds
and I am going to get a blood pressure cuff and stuff like that on.
OK
When was the last time you were at the hospital?
2010
2010? OK and what happened then?
I had a heart attack and had two stints placed.
OK. Well we will most likely what we are going to do here sir
we are going to go ahead and we are going to put some stickers on you here
and get a picture of you. I'm sure you probably had that happen before right?
Yeah
OK
So we will get this blood pressure cuff on here.
and this is going to go on your other finger over here. OK?
This is just our SPO2 monitor.
OK. And sir do you have any allergies?
Seasonal PCN and sulfur drugs.
Sulfur drugs? OK and what kind of medications do you take?
I'm on ACTZ, Nitro and Coreg.
So lung sounds are clear and respiratory rate is 24.
OK sounds good.
Well nope. Don't worry about that.
Yep. Pulse OX is on. O2 sets are a little too low.
Let's go ahead and get some low flow O2 on you.
Sir what we are going to do is we are going to put some oxygen on you.
It's going to be some nasal cannula. I'm sure you've seen something like that before
but because we are going to put some stickers on your chest as well
to check things out. We are going to pop you shirt off really quick is that OK?
Yeah.
OK
Lets take that off and then we'll out this stuff back on you here.
Thank you.
Just two leaders?
Yeah that's fine.And why don't you go ahead and lay back for us
and relax as much as you can. Thank you.
And what was the last thing you ate there sir?
I had lunch about three hours ago.
OK what did you eat?
A sandwich.
Sandwich. Was it good?
Delicious
A delicious sandwich. Alright we like to hear that.
Does that feel OK?
Yeah
Kim do you want to put these on and I'll set up your stickers for the rest of you leads.
OK
So I'll just place some stickers on you.
OK
and I think I asked you a little bit earlier but just making sure
You were just cleaning your house. You know you weren't doing anything out of the ordinary for yourself?
No
No OK perfect.
Sir do you take Aspirin?
uh no.
No OK. Well because of what you are kind of describing to us right now
with your recent cardiac history.
We're probably going to give you some Aspirin.
Do you have any GI problems? or if you ever had any hyper sensitivity to Aspirin at all?
No
No? OK perfect.
I'll go ahead and get that drawn up here.
Alright.
and what its all going to be are four little tablets. They are just chew-able.
Kind of almost like candy.
Alright
Alright.we'll just put this on your chest.
Thank you and really quick before you do that do you want to confirm that is the right stuff?
Yes.
Perfect thank you.
Sir you were talking about that you had prescribed Nitro?
Yes.
One of the worries about Nitro is taking Nitro with ED medications.
If you combine the both of them you can have a large drop in blood pressure.
and that's not good for you so what we're probably going end up giving you some
once we get an IV establish in the ambulance
I just want to make sure that you don't have any ED medications on board at this time.
No
No? OK perfect.
Ok sir here are you medications if you want to go ahead and just
pop those in your mouth and chew them up for me.
Awesome. Thank you.
Kim are you grabbing that for me?
uh huh
Thank you.
So we will just wait one second and relax
and all were are going to do is take this picture of your heart.
Just nice easy breathes
It likes to take its time to make sure it's right. Don't worry.
Alright. Here we go.
So go ahead and take nice deep breaths.
Are you in any discomfort right now other than that chest pain going on?
No
No any other problems that we need to be aware of at this time?
My arm and my neck kind of hurt.
They are a little tingly? OK alright.
and did this happen the last time in 2010 or something similar?
yeah
OK
What's it looking like Kim?
um It looks like there is some elevation.
Alright. Lets take a look at it here.
Ok sir so what we are seeing is we are seeing some elevation
In your anterior leads...anterior part of your heart.
That's usually indicative of having a heart attack.
So this is pretty serious so we are going to want to go ahead and start heading towards the hospital.
Do you have a preference to what hospital to go to?
We usually go to JMH
JMH OK. JMH is a good hospital. Because of what you are having right now
is very cardiac related I'm going to recommend that we go to JCMH
Just because they have a Cath lab and they've got cardiac specialists
and I think that would be better care for you in the long run.
Is that going to be OK?
OK
Ok sounds good.
Well we are going to get this stuff out of the way
are we are going to get you loaded on the gurney
and we are going to get headed out of here OK?
OK
Move the table over?
Yeah
We'll make sure that your coffee table gets put back.
OK
Ready?
Yeah
So what we are going to have you do is have you put your bottom right there for us sir
and we will move that O2 bag so you don't get tangled up there.
and we'll keep these chords out of your way
and we want to do this as nice and easy as possible
So whenever you are ready sir.
Go ahead and come right here for me...perfect.
and go ahead and kick your legs up as best as you can
Thank you
Alright and then go ahead and lay back for us
Alright and I am going to lay this just down here
If this is just too much just let me know OK?
We are going to buckle you in just for your safety alright?
Alright we are going to go ahead and lift you up here
Once Kim gets you buckled in and we'll make our way out of here.
OK
Scoot that way a little bit.
Whenever you are ready.
Ready
1...2...3...
I'll take that handbag.
There you go
Alright are you ready to go sir?
There we go
Ready?
Yes
Alright.