Here’s another great case from Michael M.
EMS is called to the residence of a 74 year old female with a chief complaint of chest pain.
On arrival the patient is found lying on her side in bed. She is conscious but lethargic and it’s clear she has vomited.
Skin is cool, pale and diaphoretic. She looks very ill.
The spouse states that he “thinks it’s her heart.”
Past medical history: MI x 3 years ago with stents, HTN, high cholesterol
Meds: ASA, atenolol, simvastatin, spironolactone
Vital signs are assessed.
RR: 24 shallow
Pulse: radial absent, carotid very rapid
NIBP: unable to auscultate
SpO2 does not register
The cardiac monitor is attached.
Is there anything else you’d like to know about this patient?
What is your interpretation of the ECG?
How would you treat her and why?