The patient is a 64 year old male with a chief complaint of substernal chest pain.
Onset: Sudden onset at rest.
Provoke: Nothing makes the pain better or worse.
Quality: Patient describes the pain as "sharp".
Radiate: Pain radiates to right arm.
Severity: Patient gives the pain a 15/10.
Time: 10 minutes prior to EMS activation.
Skin is cool, pale, and diaphoretic.
He denies shortness of breath. He admits to nausea but has not vomited.
Past medical history: CVA with right side deficit. IDDM with below knee amputation. Electric wheelchair bound.
Allergies: No known drug allergies
Pulse: very rapid, weak
SpO2: 99 on RA
Breath sounds are clear bilaterally.
The cardiac monitor is attached.
A 12-lead ECG is captured.
*** Update 02/13/2010 ***
A rhythm change is noted on the monitor.
An additional 12-lead ECG is captured.
Does this shed some light on the situation?