Patient with chest pain and fluctuating heart rate en route
Heard on:
Carver MN EMHRV_PI (Hospital) Group Calls
02:44
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an official report and may change.
00:00
This is Dr.
00:01
Sturman trying to reach the ambulance crew transporting the STEMI patient from Ridgeview Waconia to Abbots.
00:12
Hi, are you the crew transporting to Abbott?
00:17
Ten four.
00:20
Current heart rate is in the sixties, almost seventies.
00:25
We're working on getting another blood pressure.
00:27
We just gave him an additional nitro.
00:30
First blood pressure was 01:35 , I believe.
00:35
Received. In conversation with the current.
00:38
Cardiologist, and when we were conveying with him that patient's heart rate when he was here in the emergency department was upper forties, low fifties, and at that time he had just called me back just now and said start atropine and start or give atropine and start dopamine.
00:54
However, I would recommend against that if you are having heart rates that are sustaining in the mid fifties or higher, and certainly if you have a normal blood pressure, I would hold off.
01:05
Just give me a call in that control.
01:06
If you do notice that the patient's heart rate is sustained below fifty-five, or if you have any blood pressures under 100 systolic.
01:15
Sent for. We just got another blood pressure came back as 123 over 78.
01:21
We're just working on pulling up some morphine for him.
01:25
Do you want us to continue with nitro and morphine as the blood pressure allows, or do you want us just to go with morphine for now?
01:38
Is he getting any relief from the nitroglycerin?
01:44
No relief from the nitro so far.
01:49
I would do a max of three nitroglycerin and then if he just doesn't feel like it's helping, then I would move to just morphine at that structure.
01:59
10-4.
02:00
Do you mean a max of three nitro from us or total?
02:07
Total.
02:10
10-4. He has gotten a total of three so far without relief.
02:14
So we will be switching over to morphine.
02:17
Do you have any orders on that or do you want us just to follow our protocol?
02:23
All right, just follow your protocol on that.
02:25
Thank you.
02:29
10-4. We will continue to monitor.
02:31
He is bouncing between around 55 and then coming back up to about 70 and just kind of going back and forth.
02:39
So if we have any further continued bradycardia, we'll get a hold of you again.
Medical Emergency
