Monday, 10 January 2011

41 year old female CC: Chest pain

Here's a case submitted by Bob Sullivan from New Castle County EMS.

EMS is called to the residence of a 41 year old female with chest pain.

Onset: Sudden while sweeping the floor
Provoke: Nothing makes the pain better or worse
Quality: Tightness
Radiate: The pain does not radiate
Severity: 8/10
Time: 20 minutes prior to EMS arrival

Past medical history: MI, Pacemaker/ICD
Medications: amiodarone

Vital signs:

RR: 22
Pulse: Very rapid
BP: 150/80
SpO2: Not registering

The cardiac monitor is attached.

A 12-lead ECG is captured.

The patient is placed on O2 via NRB @ 15 LPM and IV access is established.

What do you think the paramedics should do next?