Rib Pain from the SNF

[NomadicMedic]

Thus the reason several of us asked for a 12 lead. Was this an ALS unit that transported? If so, why wasn't a 12 lead captured pre hospital?

If it was a BLS call, you did what you should have, put the patient on the stretcher and drive to the hospital.

 

[Anjel]

My teacher always says any complaint from the neck to the navel always gets an EKG.

Exceptions of course, but I definitely would of obtained one.

 

[VFlutter]

Rhabdomyolysis anyone? Assuming the EKG was indeed normal for the patient



I am guessing Boone -> Barnes?

 

[mycrofft]

Rhabdo and pulmonary embolism. Elevated trop's supposed ot be corrleated to other signs of myocardial necrosis. But in that lady, who wants to wait around for "more sings of cardiac necrosis"?

 

[PaddyWagon]

Not knowing anything more than my emt-b class work it points to a pulmonary embolism, of course basics are working from a pretty small toolkit of guesses...

1) recent surgery suggests a clot, especially in an older patient
2) shallow breathing caused by pain at inhaling
3) vitals don't suggest much else going on, as far as my limited knowledge goes
4) delayed report of pain caused by older folks not feeling as acutely as young'uns do

 

[truetiger]

It was an ALS unit. The pt had no pain unless that specific area was palpated. Cardiac didn't cross our mind.

 

[Handsome Robb]

It was an ALS unit. The pt had no pain unless that specific area was palpated. Cardiac didn't cross our mind.

You can't get em all.

That's an interesting though. My one and only STEMI as a PIC was right sided pinpoint, sharp, non-radiating, reproducible right sided chest pain with N/V and very mild SOB. Guy looked like crap though, had to hold the stickers on him to get the 12-lead he was so diaphoretic.

 

[truetiger]

Still not so sure it was a STEMI. The docs at the community hospital misdiagnose them often. The patient was admitted to a non icu bed. Her cardiologist stated that was her normal EKG. I wish I had a picture of it to post, but it was a paced rhythm and wasn't an obvious STEMI. Given that and her lack of other symptoms, I'm very curious as to the outcome.