Posts Tagged ‘ ACLS ’

STEMI in the field

Submitted.

Excellent STEMI caught in the field.

Story goes the patient had an onset of severe chest pain 15 minutes prior to EMS being activated, tried his nitro but no change. Called EMS and was showing an inferior MI on 12 lead. Since an inferior MI can be affecting the right ventricle a reverse 12 lead was performed and V4 was examined. No elevation noted. Patient treated and transported, both 12 leads transmitted and STEMI alert issued to receiving ER. Patient treated during transport for the MI. Total time from onset of chest pain to patient being in the cath lab: under 40 minutes.

I think, from what I was told, the receiving doctor activated everyone as soon as he saw the 12 lead he received. I’m not trying to say doctors don’t trust the medics when a STEMI alert is issued without the ability to transmit, but it does sound as if the doctor lit a fire under everyone involved to get this patient in and out of his ER as fast as possible.Stemi 1st Stemi 2

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Confidence

Overhead while going through quarterly intubation skills testing.

“What’s the number 1 way to be sure you have incubated someone correctly?”

Someone, “Confidence!”

Lmao! So the next time you miss, know it was probably because you didn’t believe!

Fight the Reaper

Yesterday me and mine fought a good fight against a stubborn advisary. We arrived at scene and we were guided to a patient in full arrest.

For those of you not in emergency medicine let me tell you that it is not initially exciting or thrilling in the normal sense of the words. There is a rush of adrenaline but we must take care to control its effects or risk having it derail our work.

In the past few evolutions of ACLS more emphasis has been put on cpr and keeping everyone on task. Someone isn’t doing correct cpr, correct them or rotate them out. Don’t concentrate on getting an intubation and neglect compressions. No need for time consuming IV, establish that IO.

We fought the grim reaper and we won.

During the call we have to be on task. During the call we are concentrating on not missing anything, not forgetting anything.

What is our CO2 reading? Can we do something about this new rhythm he converted to?

We fought Death and we beat it. We brought the patient back.

We celebrate after the call by thanking each other for the help. We retell the story to remind ourselves of our victory. We feel good, competent, but in the back of our minds we know we won a battle in a war we can not win forever.

Tomorrow we may battle against it again and it may not surrender. Tomorrow it may cut us.

But for today we made it back down, and that’s all we can ask for.

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