Friday, 20 November 2009

76 year old female, c/o lightheadedness with palpations and fainting episodes..

EMS responded to a 76 year old female, feeling lightheadedness with palpations and also had fainting episodes, witnessed several times by ourselves the crew on scene...

On our arrival the patient looked pale, had a GCS of 15, the patient's husband stated that his wife had been experiencing the same symptoms 2 days ago and had attended the Emergency Department, but was later discharged shortly after without a diagnosis.

The patient was given 100% oxygen via non re-breather mask, with a Spo2 of 100% on it... Sats 91% before that on air... Patient is not C.O.P.D.

This lady has a long history of heart disease, and is normally hypertensive with medication. Also you will see from the ECG strips, the patient has a pacemaker in situ... But is the pacemaker behaving itself...??? What's your opinion on this patient, please discuss your treatments and interventions also.

Please note that on the strips, that the patient became very hypotensive at times during her fainting episodes she was experiencing, due to that reason, this patient was kept supine... so all the observations taken, were in the supine position.

We have 8 ECG's here, taken at different time intervals, whilst the patient was in our care, and you will see the patient's 12-lead ECG, that was taken in the Emergency Department... so kindly make reference to which ECG you have made a comment about...

THIS PATIENT DID HAVE A PULSE, NOT IN CARDIAC ARREST!


ECG-1

ECG-2

ECG-3

ECG-4

ECG-5

ECG-6

ECG-7

ECG-8