ASA and Chest Palpitations

JPINFV said:
21 y/o female? I'd go with the Cri-Me-A River isn't just a waterway in Russia (and sometimes Ukraine).
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At 21 years old I had never touched any sort of recreational drug (or herbal or mis-used prescriptions), and don't ever plan to at almost 32. I did however have issues with low blood sugar and anxiety that caused similar physical symptoms. Don't let potential hang up on probable drug use because "everyone" does it cloud judgment and cause you to overlook things.
 
Vehement denial always raises my index of suspicion.
 
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RebelAngel said:
At 21 years old I had never touched any sort of recreational drug (or herbal or mis-used prescriptions), and don't ever plan to at almost 32. I did however have issues with low blood sugar and anxiety that caused similar physical symptoms. Don't let potential hang up on probable drug use because "everyone" does it cloud judgment and cause you to overlook things.
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Do you understand the concept of a differential diagnoses?

Do you understand that if you can't or actively don't consider a diagnosis you can't rule it out?

Do you not understand that people lie, especially young people when they think that they'll get into more trouble?

I'm not saying that it -is- drug use. I'm saying that drug use might be a cause, and as such when you have the ability to rule it out, you should do so. Perfect example. Middle age man with no psych history presents psychotic (seeing things, talking to himself, etc), fast heart rate, anxious. If you only did the drug screen, he tested meth positive. If you only checked the thyroid level, you would have found him to be hyperthyroid (thyrotoxicosis). If you considered BOTH as possible causes, you would have run both a thyroid panel and a drug screen and would have found both meth and thyrotoxicosis.
 
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JPINFV said:
Do you understand the concept of a differential diagnoses?

Do you understand that if you can't or actively don't consider a diagnosis you can't rule it out?

Do you not understand that people lie, especially young people when they think that they'll get into more trouble?

I'm not saying that it -is- drug use. I'm saying that drug use might be a cause, and as such when you have the ability to rule it out, you should do so. Perfect example. Middle age man with no psych history presents psychotic (seeing things, talking to himself, etc), fast heart rate, anxious. If you only did the drug screen, he tested meth positive. If you only checked the thyroid level, you would have found him to be hyperthyroid (thyrotoxicosis). If you considered BOTH as possible causes, you would have run both a thyroid panel and a drug screen and would have found both meth and thyrotoxicosis.
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you said the D word... no place for that in EMS

/sarcasm
 
Simple answer: you followed the complaint based approach that defines EMT and you followed your protocol.

The protocols are there because EMTs do not have sufficient education, training, and diagnostic tools to exercise thorough assessment and more flexible treatment. Consequently they all cover treatments have a massively low risk if unneeded vs a massively high potential reward if needed. THAT DOESN'T MEAN DISENGAGE YOUR BRAIN.

A thinking EMT might have utilized protocol flexibility to defer the ASA administration until completing more thorough assessment and possibly trying some other avenues.

What can enable you when the protocol is not the best path? CALL MEDICAL CONTROL. The person on the other end of the biophone has the education and experience to confirm your concerns and illuminate you on thoughts you didn't have.
 
I would not have given aspirin. A healthy 21 yo is highly unlikely to be having an ischemic cardiac event and the symptoms described don't lean towards such.

Did it hurt? Of course not. People buy aspirin at walmart and take it everyday. But I'm not hearing any indication for aspirin.
 
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