Thanks to Dave StatterÂ for turning me on to this story from the Washington Post.
Apparently a 39 year old male died a few hours after paramedics diagnosed his chest pain and shortness of breath as acid reflux and prescribed him Pepto-Bismol.
Here’s a quote from the story.
“Lolitha Givens said the firefighters asked her son what was wrong, and the emergency medical technicians who arrived by ambulance checked his vital signs and performed an electrocardiogram, the results of which they said were normal.”
While it’s possible that the ECG was “normal” I’d love to see it!
That’s assuming it was a 12 lead ECG and not a rhythm strip.
Does the absence of acute changes mean the patient is experiencing acid reflux? I must have missed that report in the New England Journal of Medicine.
Maybe it was the same issue that explains how acid reflux causes shortness of breath.
In realityÂ 1-4% of patientsÂ who present to the emergency department with chest pain and a normal ECG are ultimately diagnosed with acute myocardial infarction.
The press release by Fire Chief Dennis Rubin states:
“I was notified today about a specific medical call that is currently under investigation by the DC Fire & EMS Department.
At 11:40 last night, Paramedic Engine 30 and Ambulance 30 were summoned to an address in Northeast for a person having trouble breathing. Personnel responded quickly, in just over four minutes, and patient assessment was promptly started. Personnel provided service on the scene, but the patient, identified as an adult male, was not transported to the hospital.
Authorities responded back to the same location early today and found the same patient deceased.
As per protocol, we are conducting a thorough quality assurance case review and we will determine whether proper care was provided and if the two medical events are related. Until this investigation is complete, we will not be able to make any further comment.”
I hope it’s a coincidence, too, Chief.
Either way, if the allegations are true, it’s disturbing to say the least.
This coming right on the heels of the report that a Captain and wagon driver from Engine 30 became involved in a physical altercation on a medical call.
This is an important reminder for all of us.
The only chest pain patients who should not be transported to the emergency department are those who adamantly refuse care against medical advice.