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This is Ambulance 292 responding emergent with a full crew and no delays from headquarters to the Kevorkian Clinic for a reported chest pain. During transport disptach informed us that the patient is alert and breathing.
Unit 292 arriving on scene.
Our patient is Frederich Neizche he was born February 8th, 1986. He is a 38 year old male. Complaining for severe 10/10 chest pain. He is receiving oxygen via a nasal cannula and is lying on the exam table in room 1.
Frederich can you tell me what's going on today?
About two hours ago I was sitting and watching TV in my living room and I began to feel a sudden crushing pressure in my chest.
Do you have any shortness of breath?
No, but I do feel nauseous and dizzy. I've also been sweating a lot. I took one of my nitro tabs but it didn't help. Any time I stand up or try to do any activity the pain gets worse. I feel a little better when I'm laying down.
Does the pain radiate or move?
I also have pain to my jaw and down my left arm.
On a scale of 1 to 10, with 10 being the worst pain you've ever felt in your life and 1 being almost no pain what is it right now.
It's a 10. It's really bad.
According to the paperwork provided by the doctor here Frederich has a known medical history of coronary artery disease, hypertension, high cholesterol, type 2 diabetes, BPH, GERD and a previous MI in 2018 with two cardiac stents placed.
The doctor has placed an IV in the patients right arm, and gave them another dose of sublingual nitro. He also did an EKG which show ST Elevations in leads II, III, and aVF with a reciprocal ST Depression in aVL.
Do you have any allergies?
Only to cats and kiwi.
What medications do you take?
I take metoprolol for my blood pressure, eliquis, and metformin.
Okay great. I'm going to do a quick exam.
Sure go ahead.
patient is alert and oriented to person place time and event. He appears pale and diaphoretic and in obvious pain. He is dressed in normal clothes and appear to be well groomed. Frederich's skin is pale, cool and diaphoretic. skin is intact. There are no rashes or bleeding. Airways a patent with good air movement. he is able to speak in full sentence. Trachea is midline. The chest is atraumatic without bruising, implanted devices or flail segments. heart rate is rapid, regular and weak. Distal pulses are palpable but thready. No edema noted.
Lung sounds a clear and equal bilaterally. Chest expansion is adequate and even. Respiratory pattern is regular and elevated with increased work of breathing.
Frederich is calm and his behavior is appropriate to the situation. thought pattern and speech are organized no bizarre behavior noted.
EKG shows Sinus Tachycardia at 100 with PVCs. ST Elevations in Leads II, III, aVF with reciprocal ST Depression in aVR.
Blood sugar is 84.
Vitals are 102/54, heart rate 100 weak and regular, 17 breaths per minutes regular and labored, SpO2 is 98%, EtCO2 is 33.
Okay Frederich it looks like you might be having what we call an Inferior Wall MI, it's a kind of heart attack. I don't want you to worry we are going to take great care of you.
Do I need to go to the hospital?
Absolutely! We are going to head over to St. Nicholas Medical Center to get to squared away, okay? We're going to be driving emergent and I'm going to notify the hospital that we are coming to they will be ready for us when we get there.
Uhh, okay. I'm scared.
Medical Control this is Wantagh-Levittown VAC unit 292 with an STEMI notification.
Go ahead wantagh-levittown.
Medcomm this is Wantagh-Levittown VAC unit 292 transporting a 38, three eight, year old male with an inferior wall STEMI. Patient has been having profound chest pain for the last two hours, starting while he was at rest. Vitals are 102/54, Sinus rhythm sinus tachycardia 90s to 120s. SpO2 98 percent on room air. Our eta to you is 15 minutes, requesting the cath lab.
Thank you 292. You are expected.
Alright, lets get you into the ambulance. Take a seat here on the stretcher. We're gonna keep you connected to the monitor.
Hey Siri set from scene time.
List of treatments provided by EMS: Patient was treated with a 20 gauge IV in his right forearm. 325mg of chewable aspirin administered. Patient was given 100mcg of Fentanyl IV which reduced his pain to 3. A liter bag of normal saline was hung but not administered. Serial 12-lead EKGs were performed with no changes. Oxygen administration was withheld as patient's oxygen saturation stated above 94% throughout transport.
Patient was assisted to stretcher
Patient secured with three straps
Monitoring: Transport Monitor, Cardiac Monitoring, End Tidal CO2 Monitor
Belongings transported with patient in care of family member.
Clinical Status / changes: Transport was begun without delays. During transport Frederiche's stated a reduction in pain to 3. His color improved and heart rate slowed to the 80s.
Upon arrival at the hospital Full report and paper work was given to Johnson, RN with all questions answered.
the patient was transferred to: emergency department bed 3 via draw-sheet and left with rails up, wheels locked, in staff presence.
Crew delayed at receiving facility due to crew delayed while waiting for bed to be cleaned.
292 was cleaned, restocked and returned to service.