AMI

fair warning: this will only be interesting to medical nerds

No, the fact that a person was having an Acute Myocardial Infarction (aka: AMI, MI, heart attack) does not make me happy. But the fact that the first and second due Medic Units were all out on calls and I got to run it, that made me happy.

It was an atypical presentation. Some chest pain, no trouble breathing, felt weak for the last half hour, no diaphoresis, no n/v, no headache, he was pretty nonchalant about the whole thing. Diabetic was the only medical history. D-stick 350, ate 3o min ago and didn't take insulin. The EKG was initially the top strip, appeared to be a 3* heart block (maybe with one box of ST elevation) bradicardia. Saw that and decided to get the patient out of the house and on the Medic for a 12 lead and some interventions. note: I am the only medic on scene. I am alone. I dislike not having anyone to consult with. The 12 lead is the middle strip. In that 5 minutes between strips the ST elevation skyrocketed. And in all leads but two. Oh crap. From there you know the drill... MONA. Well O, N, no A (he was allergic), then M.

While responding I decided to warn him about what was happening, and what was about to happen. He said "Oh. I thought it might be that. My Dad died of a heart attack." without any affect, like he was asking me to pass the butter or something. Sheesh. I told him the next time he feels like this to please tell the medic "This is what it felt like last time I had a heart attack." We were only a mile from PWH so took him there instead of flying him to Fairfax.

The last EKG was taken 5 minutes after the middle one, ST elevation had gotten higher and the heart rate was now tachicardic. Thank goodness we were rolling up to the ambulance bay. By the time I was done writing my report and refilling the narc pack, they had a helicopter there to take him to the cath lab at IFH.

It was a good call. I love my job.