• Scene – IV 20G, 12 lead, O2, NTG, CBG
• En route – VS EKG
• Hospital – n/a
• Response to treatment – relieved some but not all pain
• Disposition – Unknown
• Elliot Williams, Paramedic Woodburn Ambulance
• David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center
• Cough
• Shortness of breath
• Pneumonia
• Myocardial Infarction
• Congestive heart failure exacerbation
• Pulmonary edema
• Pulmonary embolus
• COPD exacerbation
• Patient states – Has had cough for 2 days and chest hurts with breathing (pleuritic pain), which makes her cough.
• Pain with inspiration
• Productive cough, mostly clear.
• Pedal edema
• GCS – 15
• EKG – Afib
• CBG – 96
The routine work of a paramedic involves continuous multi-tasking. Notice how the paramedics work as a team, while engaging the patient, while moving forward in their progression of assessment and treatment of the chief complaint.
-Dr. David Spiro
Suggested References
Diagnostic approach to chest pain in adults
Chest pain evaluation by EMS personnel
• Gender: Female
• Age: 83 years
• Height: Not Available Vitals
• Temperature: 97.4 F/36.3 C
• Blood Pressure: 121/75
• Heart Rate: 106
• Respiratory Rate: 18
• Pulse Oximetry: 95% RA
Shortness of breath; cough; chest pressure
• PMH: Hypertension; renal disease.
• Allergies: Lasix; sulfa
• Dispatch info: Shortness of breath; cough; chest pressure.
• Lives alone but has network of friends.
• Moving to assisted living facility in near future.
• Coumadin; nitroglycerin
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