About 2 weeks ago, 46 y.o. male presents to ED with c/o crushing chest pain. Saw him rolling in on the stretcher from across the room, thought he looked bad, new grad assigned the room, thought I could maybe help.
Getting pt settled in, EKG failed to show acute MI. Plenty of ugly ST depression. On monitor pt began to throw mulitfocal PVCs, another RN noticed and rehooked him up to the EKG..... went into Vfib during the EKG.
Coded the patient for 40 mins. He would go from vfib to PEA to vfib to PEA. I helped compress, give meds and press the shock button. We worked our h's and t's. We must have shocked him at least 5 times.
We almost quit efforts. WE PERFORMED COMPRESSIONS FOR 40 MINUTES.
Finally got a pulse back. About 20 mins later he began to show signs of cognitive function, moving his arms. They took him to the cath lab.
He was discharged to home today with an AICD. HE HAS NO COGNITIVE DEFICITS! Now thats some high quality CPR, baby! His wife is singing our praises :)
I am so proud to be part of it. I almost cried when I heard that he lived. This is why i became a nurse. :redpinkhe
Sounds like maybe a posterior MI (Ie the "wide spread ischemic changes". Good job to you guys though!!!
Happy
Yeah, not sure. No ST elevation. Didn't have much time to look at it for obvious reasons.
It was actually a mess. He was a super hard intubation. Had to call a second doc in to try. Then he vomited everywhere during the whole thing- ended up with aspiration pneumonia.
I know the pt will be coming back for a CABG sometime in the future. I will find out more in the coming weeks. He supposed to come in and see us.
Specializes in Adult and Pediatric Vascular Access, Paramedic.
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Yeah, not sure. No ST elevation. Didn't have much time to look at it for obvious reasons.
It was actually a mess. He was a super hard intubation. Had to call a second doc in to try. Then he vomited everywhere during the whole thing- ended up with aspiration pneumonia.
I know the pt will be coming back for a CABG sometime in the future. I will find out more in the coming weeks. He supposed to come in and see us.
In a Posterior MI you will see ST segment DEPRESSION in v1-v3/v4.
His wife is singing our praises :)
AnnieOaklyRN, BSN, RN, EMT-P
2,611 Posts
Sounds like maybe a posterior MI (Ie the "wide spread ischemic changes". Good job to you guys though!!!
Happy