Mohrenberg
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I am finishing up clinicals for paramedic school, and went on a chest pain last night with a Medic based out of the ED.
The call was toned as an 82 year old male complaining of chest pain.
He said his pain start 3 hours prior and he had thought it was indigestion, when unable to fall asleep, he called 911.
Described the pain as sharp, radiating to his jaw rating it a 7/10.
Patient had a hx of MI in 1995, 6x cardiac stents, pacer on his left side, copd, ect..
Anyways, while enroute he kept throwing wide complex qrs's on the monitor, the medic said it was his pacer but I never saw any pacer spikes. They would be random, and then every once in a while he would go into a bigeminy rhythm.
at one point, I looked over at the monitor and saw what looked like Vtach at 115bpm on the monitor.. I looked over at the patient who was still AO, asked, "How are you feeling?" he replied he felt fine, so i checked his radial which was present. I tapped the medic on the shoulder who was doing something in the cabinets, and she said it was his pacer.
I didn't know that pacers fire at 115bpm?
Then the patient said his chest was starting to "burn" like he was "being pushed through a small hole" (that's a new one for me)
His rhythm then converted back.
So i'm trying to find out, were these really paced beats, or was this guy in bigeminy with runs of vtach?
Unfortunately I don't have a strip of the vtach, but I've got a strip of the bigeminy.
The call was toned as an 82 year old male complaining of chest pain.
He said his pain start 3 hours prior and he had thought it was indigestion, when unable to fall asleep, he called 911.
Described the pain as sharp, radiating to his jaw rating it a 7/10.
Patient had a hx of MI in 1995, 6x cardiac stents, pacer on his left side, copd, ect..
Anyways, while enroute he kept throwing wide complex qrs's on the monitor, the medic said it was his pacer but I never saw any pacer spikes. They would be random, and then every once in a while he would go into a bigeminy rhythm.
at one point, I looked over at the monitor and saw what looked like Vtach at 115bpm on the monitor.. I looked over at the patient who was still AO, asked, "How are you feeling?" he replied he felt fine, so i checked his radial which was present. I tapped the medic on the shoulder who was doing something in the cabinets, and she said it was his pacer.
I didn't know that pacers fire at 115bpm?
Then the patient said his chest was starting to "burn" like he was "being pushed through a small hole" (that's a new one for me)
His rhythm then converted back.
So i'm trying to find out, were these really paced beats, or was this guy in bigeminy with runs of vtach?
Unfortunately I don't have a strip of the vtach, but I've got a strip of the bigeminy.
![qrs.jpg](/proxy.php?image=http%3A%2F%2Fmohgasm.com%2Fqrs.jpg&hash=f54ee09b52dbc4eddbf925d6ee2c4833)