Here's a case submitted by Captain Jack Sparrow from the UK Ambulance Forum.
I'm presenting it here with minor modifications.
Turns out Mark Glencorse isn't the only clever Brit! We Yankees can learn a lot from the way they do things across the pond.
EMS is called to the residence of a 69 year old male with a chief complaint of chest pain.
- Onset: Gradual while driving
- Provoke: Nothing makes the pain better or worse
- Quality: Describes pain as pressure
- Radiate: The pain does not radiate
- Severity: 3/10
- Time: Similar episode over the weekend while gardening
Past medical history: CVA x 13 years ago, AF
Past surgical history: None
Allergies: No know drug or environmental allergies
Medications: Warfarin, digoxin, others
On arrival the patient is found sitting in a chair.
Skin is pink, warm, and moist.
He appears ill.
- RR: 16 regular
- Pulse: 130 irregular
- NIBP: 137/102
- GCS: 15
- BGL (BM): 146 (8.1)
- SpO2: 99 on RA
Breath sounds: clear bilaterally with normal air entry
No obvious trauma or anything else out of the norm.
The cardiac monitor is attached.
A 12-lead ECG is captured.
What's wrong with this patient?