Actual call here. Not super exciting but figured I would post more IFT calls since we don't get a ton in the scenario section. Keep in mind, we are a CCT truck in LA County which means we have a CCT-RN and 2 EMT's on board.
You are called for a non-emergent transfer of a 84yo female with a diagnosis of NSTEMI around 1AM. She is being transferred from a telemetry bed at one hospital to a telemetry bed at a hospital her insurance plan wants her at after they deemed her "stabilized". She was going to be transferred for a cardiac catherization the day before but the patient initially refused however has stated that she will talk it over with her family in the next couple days and make a decision.
C/C: Chest pain on/off 2-3 days, dull, left and right side with a 6/10 score. Non-radiating and no pain upon palpation. States she has not had chest pain recently, this is new.
Hx: Hypertension, hyperlipidemia and a left adrenal adenoma. No major or recent surgeries and no allergies
Home medications: Lisinopril and Atorvastatin.
Diagnosis: NSTEMI and Diverticulitis.
Tx: Aspirin 325mg, nitro x2 and a Heparin GTT. Noted to have no chest pain after treatment started and has remained on the Heparin drip at 850 units/hr with no pain since while on the telemetry floor.
Vitals after on our gurney: HR 80 NSR, BP 101/62, SP02: 95% on RA and R 16. No pain and has not had pain since being treated in the ER 2 days prior.
Plan: Transfer her to her insurance accepted hospital, continue heparin, treat her diverticulitis while she decides if she wants to have a cardiac cath, which the cardiologist recommended.
Halfway through transport, your patient states that she has 6/10 left sided dull chest pain and a "slight" discomfort in her chest. Her vitals at this time are: HR 84, BP 99/66, SPO2 90% and R 14 and she is still on the Heparin GTT. You place her on 2L NC which bumps her SP02 to 96% but provides no other relief. You perform a 12lead EKG that is below. What is your next move?
1. Continue the 10min transport to the destination hospital which is not a STEMI receiving center to her inpatient room.
2. Continue the 10min transport to the destination hospital but divert to the ER instead of the telemetry floor so she can be seen by a Dr immediately.
3. Divert your destination to the STEMI receiving center which is 16min away.
You do not have 12lead transmit capabilities and CCT does not work under a base hospital so you don't have the luxury of calling for advice.
I will try to post more IFT calls because it's different than 911 and we definitely get some interesting ones lol
You are called for a non-emergent transfer of a 84yo female with a diagnosis of NSTEMI around 1AM. She is being transferred from a telemetry bed at one hospital to a telemetry bed at a hospital her insurance plan wants her at after they deemed her "stabilized". She was going to be transferred for a cardiac catherization the day before but the patient initially refused however has stated that she will talk it over with her family in the next couple days and make a decision.
C/C: Chest pain on/off 2-3 days, dull, left and right side with a 6/10 score. Non-radiating and no pain upon palpation. States she has not had chest pain recently, this is new.
Hx: Hypertension, hyperlipidemia and a left adrenal adenoma. No major or recent surgeries and no allergies
Home medications: Lisinopril and Atorvastatin.
Diagnosis: NSTEMI and Diverticulitis.
Tx: Aspirin 325mg, nitro x2 and a Heparin GTT. Noted to have no chest pain after treatment started and has remained on the Heparin drip at 850 units/hr with no pain since while on the telemetry floor.
Vitals after on our gurney: HR 80 NSR, BP 101/62, SP02: 95% on RA and R 16. No pain and has not had pain since being treated in the ER 2 days prior.
Plan: Transfer her to her insurance accepted hospital, continue heparin, treat her diverticulitis while she decides if she wants to have a cardiac cath, which the cardiologist recommended.
Halfway through transport, your patient states that she has 6/10 left sided dull chest pain and a "slight" discomfort in her chest. Her vitals at this time are: HR 84, BP 99/66, SPO2 90% and R 14 and she is still on the Heparin GTT. You place her on 2L NC which bumps her SP02 to 96% but provides no other relief. You perform a 12lead EKG that is below. What is your next move?
1. Continue the 10min transport to the destination hospital which is not a STEMI receiving center to her inpatient room.
2. Continue the 10min transport to the destination hospital but divert to the ER instead of the telemetry floor so she can be seen by a Dr immediately.
3. Divert your destination to the STEMI receiving center which is 16min away.
You do not have 12lead transmit capabilities and CCT does not work under a base hospital so you don't have the luxury of calling for advice.
I will try to post more IFT calls because it's different than 911 and we definitely get some interesting ones lol
