Here's an interesting and somewhat unusual case submitted by a faithful reader who wishes to remain anonymous.
EMS is called to the residence of a 82 year old male complaining of shortness of breath and weakness.
On arrival the patient is found slumped sideways in a chair.
He is weak and in significant distress, repeating, "Oh Lord…. Oh Lord…"
Past medical history: HTN, NIDDM
The patient is African American.
Skin is diaphoretic. Nail beds are bluish. Capillary refill is delayed.
Breath sounds: Basilar rales
Vital signs are assessed.
RR: ~30 (estimated)
Pulse: 36 Irregular
SpO2: 88 on RA
The cardiac monitor is attached.
A 12-lead ECG is captured.
An IV is established and labs drawn.
How would you describe this patient's condition?
What is your treatment plan?