Not that having to change the direction of your care is anything new, but had a good one the other day. Nutshelled... This pt loves to cry wolf and loves to be the director of their care. Has a few minor medical issues, but none that usually result in true emergent events. Finally, a while back called us for abdominal pain mid upper quads. Mind you, not debilitating or with vomiting at the moment, but onset with eating of some foods. I correctly called it gallbladder and nicely gave transport, despite family being on hand with plenty of vehicles. I was coached by the patient on every aspect of treatment on the way, including IV placement. Fast forward to a short time ago... same patient, with right side abdominal pain. The pt did indicate the upper left quad, but also said it was felt from mid quad, epigastric region over to the left side. Pt says pain is a 7/10 scale. Im thinking upper GI, anything from gas to ulcer to diverticulitis. I walked the pt to the truck, and made them as comfortable as possible. I placed the IV and my pard put the monitor in place and ran me a 4 lead strip. Up to this point I was in my relaxed mode, not that my demeanor changes much when I feel urgency. I looked at the strip and and looked at my partner and said In all likely-hood this aint what it seems, lets go! (My usual transport phrase is Im all set, nice easy ride, So he knew something was up and to move with urgency.) 2, 3, AvF all had elevation. I placed a 12 lead as we left scene and also found elevation in V5, and V6 with depression in V1, and V2. You pretty much know the drill from there. The only thing disappointing from here on out in the call was the hospitals slow approach to a STEMI event arriving, despite being told as much. They cry wolf long enough, one is likely to show up
Posted on: Sat, 29 Nov 2014 13:22:49 +0000
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