Definitely unprepared for this call. Curious to see what you would have done differently treatment wise and for more clarification of unstable and stable v-tach.
Work for IFT company and called to nursing home for ER transfer with unknown complaint. Arrive to find elderly pt appearing hemodynamically stable with c/c of SOB with accessory muscle use. Pt AOx4, rhonchi in upper lobes, clear lower lobes, tachy radial pulse, and 34/min resp rate labored, -fever/chills/night sweats, and -pain.
Nurse states pt has been SOB since this morning, no O2 treatment due to SpO2 96%, Denies any resp or cardiac Hx, only Hx of CA mylenoma, and NKDA.
Pt placed on O2 15LPM NR, loaded into ambulance where ECG showed V-Tach, BP was unable to obtain but pt AOx4 and with radial pulse, and hospital 1/2 mile away. Defib pads placed.
Would you consider this pt unstable and shock him, treat with lidocaine, or transport as stable vtach knowing worst case scenario pt codes with only paramedic and emt and only enough time to let receiving hospital know we are pulling in.
Work for IFT company and called to nursing home for ER transfer with unknown complaint. Arrive to find elderly pt appearing hemodynamically stable with c/c of SOB with accessory muscle use. Pt AOx4, rhonchi in upper lobes, clear lower lobes, tachy radial pulse, and 34/min resp rate labored, -fever/chills/night sweats, and -pain.
Nurse states pt has been SOB since this morning, no O2 treatment due to SpO2 96%, Denies any resp or cardiac Hx, only Hx of CA mylenoma, and NKDA.
Pt placed on O2 15LPM NR, loaded into ambulance where ECG showed V-Tach, BP was unable to obtain but pt AOx4 and with radial pulse, and hospital 1/2 mile away. Defib pads placed.
Would you consider this pt unstable and shock him, treat with lidocaine, or transport as stable vtach knowing worst case scenario pt codes with only paramedic and emt and only enough time to let receiving hospital know we are pulling in.