Tuesday, 30 November 2010

Tom Bouthillet and Jamie Davis discuss the 2010 AHA ECC Guidelines with Monica Kleinman, M.D. and then discuss cardiac arrest and the chain-of-survival

Part I - Jamie Davis and Tom Bouthillet discuss the 2010 AHA ECC Guidelines with Monica Kleinman, M.D., incoming Chair of the AHA's ECC Committee.



Part II - Jamie Davis and Tom Bouthillet discuss the 2010 AHA ECC Guidelines with Monica Kleinman, M.D., incoming Chair of the AHA's ECC Committee.



Part III - Jamie Davis and Tom Bouthillet discuss cardiac arrest and the chain-of-survival.

73 year old female CC: Chest pain

EMS is called to the residence of a 73 year old female with a chief complaint of chest pain.

On arrival the patient is found sitting on the couch. She appears acutely ill.

Skin is pale and diaphoretic.

Onset: 1 hour ago
Provoke: Nothing makes the pain feel better or worse
Quality: Heaviness or pressure
Radiate: Pain radiates to neck and jaw
Severity: 7/10 and persistent
Time: No previous episodes

Past medical history: HTN, dyslipidemia, breast CA

Medications: Unknown

The patient admits to mild dyspnea but breath sounds are clear.

Vital signs are assessed.

RR: 18
Pulse: 96
BP: 172/72
SpO2: 98 on RA

The cardiac monitor is attached.



A 12-lead ECG is captured.



Displeased with the data quality, paramedics capture another 12-lead ECG.



What do you think is wrong with this patient?