MI

A guy passed out driving, had severe chest pain in his right arm. He was awake when we got there, but he looked like crap. Pale, grey, like death. He was holding his chest. He was only forty, but he looked sixty. Some hard miles on him.

I put him on the monitor. Massive Tombstone ST elevation in the inferior leads with the characteristic depression inverse elevation in VII and III that suggests posetrior involvement. I did a quick MCR4 to look at his right ventricle. Tombstone there as well.

02, ASA, double lines( a 14 and a 16) all on the way to the hospital. I called ahead to tell them I was coming in with an acute MI.

They were ready -- not a free pass to the cath lab, but at least they had a room and nurse waiting with their 12 lead machine and she called the doctor over as soon as I came in. He was on the phone to the cath lab shortly after that -- he didn't even wait for their ECG-- and they were getting ready to wheel the patient up to the cath lab as I was leaving.

Someday they will let us go right to the cath lab, but in the meantime, I think having the doctor nurse and room ready works okay.

I heard later they cleared the blockage and put in a stent. He’s in intensive care, but doing all right.


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Gave morphine to a lady with kidney stones. Did another abd pain and an MVA