Dispatch
Medic 4 was dispatched to the above-listed address for chest pain.
Chief Complaint
Pt is a 62 YOM with a chief complaint of chest pain. Pt was located sitting at a residence in the living room. Pt was alert upon arrival.
History
History was obtained from Pt. Pt has a history of hypertension and hyperlipidemia. Pt denies recent surgery or other pertinent history. It was reported that pressure started while Pt was watching television. Pt denies loss of consciousness and a head strike.
Allergies: no known drug allergies. Medications: a list was given to the ED. Last oral intake was dinner.
Events leading up: Pt was seated on the couch when the pain started and asked a family member to call 911.
Onset was sudden. It is provoked by nothing. Quality is pressure. Radiation: to the left arm. Severity 7/10. Time constant since onset.
Assessment
Airway is intact. No airway compromise noted. Respirations are initially 20. Respirations are regular, adequate, and unlabored. Initial BP was 158/92. Pt's initial pulse is 96. The pulse is strong and regular. The Pt's skin is pink, warm, and dry. Capillary refill is less than 2 seconds. Pt appeared emergent. ER evaluation is indicated for chest pain.
Physical Exam
Head: atraumatic, symmetrical, and unremarkable. Pupils are equal and reactive. Pt is AOx4.
Neck: no JVD and the trachea is midline.
Chest: Pt reports chest pain and denies shortness of breath. No paradoxical movement noted. Lung sounds are clear on the left and on the right. Pt is negative for seatbelt sign.
Abdomen: soft and nontender. Pelvis is stable. Back is unremarkable.
Extremities: pulses are present and equal. No edema. Pt is negative for DCAP-BTLS.
Diagnostic Tests
SPO2 96% on room air. Blood glucose 118 mg/dL. ETCO2 38 mmHg. 12-lead ECG shows sinus rhythm with ST elevation in the inferior leads.
Primary Impression
STEMI.
Medications and Procedures
Aspirin 324 mg was given PO, chewed, at 1412. Pain improved from 7/10 to 5/10. No adverse reaction.
Nitroglycerin 0.4 mg was given SL at 1416. Pain improved to 3/10. No adverse reaction.
An 18 gauge IV was placed in the left forearm and flushed with 10 mL of normal saline.
Transport
Pt was transported emergent to Miami Valley Hospital. Pt remained stable during transport. A report was called in prior to arrival. A cardiac alert was recommended. Pt was released to the RN staff in the cath lab in a stable condition.