So, I'm sitting here, working on the never ending mass of paperwork, and I can't help but to think that I could've done something differently...
Here's what happened...
Got a call at 6am for chest pain. Arrived onscene to find a 50 year old female sitting on the sofa, awake, alert, and oriented. She's c/o sternal c/p, rates 8/10, described as "dull" and "constant". She's also co/o n/v which started before the c/p Currently not vomiting, still feels nauseated. The c/p is non radiating, no diaphoresis, no SOB, and is mildly tender to palpation right above the zyphoid process. Only hx is HTN, takes antihypertensives. Checked a set of vitals...pressure was 150/98, HR 92 and regular, RR 18 and regular, SPO2 98% on RA. Put her on the monitor, SR w/out ectopy. Put her on O2, and loaded her up.
We've got ridiculously short transport times to the ED...this one was around 5 min. I rechecked vital signs, gave her ASA, started a saline lock, considered doing a quick 12 lead but her outfit would have required me to completely undress her in order to perform a 12 lead, and we were only a min away from the ED at this point (any longer, and I'd have rigged up some sort of privacy screen out of a sheet or something creative like that, but were were almost at the ED). I verified no allergies, and was about to give her some nitro...when damn! She did a sort of tonic seizure thing for about 30 secs, then became unresponsive. I suctioned her airway, put her on a NRB. She still had gasping respirations at about 10-12 a min. I noticed she was in a SB rhythm at this point, at a rate of about 45. Still had a pulse...
We were pulling up at the ED at this point, so I elected to just throw the monitor on the stretcher and roll with it, instead of trying to work this mess in the back of an ambulance sitting at the ED parking lot....
Anyways, she coded and died, probably a massive MI.
So, I'm sitting here, wondering if there's anything I could've done differently....I care deeply about every single one of my patients, and the thought that I missed something that could've saved her life just eats me up inside....
What do y'all think?
Here's what happened...
Got a call at 6am for chest pain. Arrived onscene to find a 50 year old female sitting on the sofa, awake, alert, and oriented. She's c/o sternal c/p, rates 8/10, described as "dull" and "constant". She's also co/o n/v which started before the c/p Currently not vomiting, still feels nauseated. The c/p is non radiating, no diaphoresis, no SOB, and is mildly tender to palpation right above the zyphoid process. Only hx is HTN, takes antihypertensives. Checked a set of vitals...pressure was 150/98, HR 92 and regular, RR 18 and regular, SPO2 98% on RA. Put her on the monitor, SR w/out ectopy. Put her on O2, and loaded her up.
We've got ridiculously short transport times to the ED...this one was around 5 min. I rechecked vital signs, gave her ASA, started a saline lock, considered doing a quick 12 lead but her outfit would have required me to completely undress her in order to perform a 12 lead, and we were only a min away from the ED at this point (any longer, and I'd have rigged up some sort of privacy screen out of a sheet or something creative like that, but were were almost at the ED). I verified no allergies, and was about to give her some nitro...when damn! She did a sort of tonic seizure thing for about 30 secs, then became unresponsive. I suctioned her airway, put her on a NRB. She still had gasping respirations at about 10-12 a min. I noticed she was in a SB rhythm at this point, at a rate of about 45. Still had a pulse...
We were pulling up at the ED at this point, so I elected to just throw the monitor on the stretcher and roll with it, instead of trying to work this mess in the back of an ambulance sitting at the ED parking lot....
Anyways, she coded and died, probably a massive MI.
So, I'm sitting here, wondering if there's anything I could've done differently....I care deeply about every single one of my patients, and the thought that I missed something that could've saved her life just eats me up inside....
What do y'all think?