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95 year old female chest pain

by on September 16, 2016

EMS received a call for a 95 yo female who began having chest pain x 2 hours with nausea.  Pt has a hx of dementia.  Pain is 10/10.  EMS obtained a 12 lead ekg.  LBBB with positive Sgarbossa criteria for concordant ST elevation in the inferior  and lower lateral leads with concordant ST depression in V1-V2.

lbbb2

EMS calls for air medical transport since the nearest PCI center is an hour away.  Prior to air medical transport arrival pt has been given 4mg MS, 325mg ASA, and 4mg Zofran

IV is patent running kvo rate BP is now 83/47  Respirations 20 and pulse is 54.

Air medical crew initiates another IV and runs fluid w/o to bring BP up to 107/55.  Pt is dropped off at the Cath Lab.

sgarbossa2sgarbossa3

 

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