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Frank, I dont work in a rural area. We tx and transport hot MIs all year long so I'm afforded the opportunity to view real time 12 leads and even 15 leads when indicated. So, the senario presented with with a 12 lead indicating anterior lead elevation and I will even throw in reciprocal changes...

Mike, I think you are 1 of 2 people replying who actually understood my question. Yes. In the scenario, the cardiac event is due to a blockage indicated by ST elevation in the anterior leads on the 12 lead. I'm my experience, diabetic women sometimes do not perceive pain like the average...

Gotcha.. this is interesting ...we r in Florida and routinely give NTG for chest pn

So again I will reiterate. The atypical present resprents the fact that diabetic woman are infamos for having silent MIs. The diabetes results in them not perceiving pn as a patient without diabetes. My point is, in the same scenario on a pt with no Hx will most likely have chest pn in the...

Ok, so you wouldn't give NTG for chest pain if your pt was experiencing a STEMI in the prehospital setting ? As of today, we use NTG to tx chest pn. All variables aside, the question was in reference to prehospital administration of NTG for a silent MI. Reduction of preload and coronary artery...

Yes, my scenario is a confirmed STEMI. Our protocols indicate NTG for chest pain only. I was debating a co-worker regarding atypical presentations giving NTG with no pain during a Hot MI. The pain is just a symptom of the underlying issue which is ultimately why you are administering NTG. So...

BP is 160/90, HR 88 Patient is a diabetic experiencing a "silent" MI. Typical chest pn resolved using NTG is the result of restoring blood flow to an ischemic area. So, if you ID a stemi, Wouldn't the patient benefit even in the absence of chest pn?

Scenario: 60 y/o diabetic woman with a Chief complaint of weak, diphoretic, and nausea. No chest pain 12 lead shows ST Elevation in the anterior leads . Would you administer Nitro assuming BP is good ?

Yes, the time settings are different. The LP software speeds up the capnography monitor display to make it "real time" and prints it out normal. A pt breathing 12 bpm wouldn't even show up on the monitor without manipulating the speed. Our last pts capnography print out showed 4 breath cycles...

Senario: Pts RR 40 BPM. Waveform capnography on the LP20 was consistent with the pts presentation. However, the printed version of the waveform, with no change in the pts RR, appeared slower and elongated. Solely looking at the printed waveform with no information regarding the pts actual RR...