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EN ROUTEIt is 0930 and you are staffing a 2-paramedic transp…

Posted byAnonymous August 26, 2025September 2, 2025

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EN ROUTEIt is 0930 аnd yоu аre stаffing a 2-paramedic transpоrting ambulance. Yоur unit is dispatched for a 68-year-old male with chest pain. He has a history of diabetes, high cholesterol, and high blood pressure. It is a rainy spring day, and the temperature is 75F (24C). The response time is about 8 minutes. There is a community hospital about 15 minutes away, and a level 2 trauma center with most capabilities about 25 minutes away.Dispatch notes the patient woke from sleep with severe chest pain. The patient’s wife is on scene. ON SCENEThe wife leads you into the bedroom where you find the patient (60kg) sitting on the edge of the bed leaning forward with his hands on his thighs.  He makes eye contact when the crew arrives but appears tired and is in moderate respiratory distress. The wife states that the patient was feeling dizzy and had a headache last night but woke up suddenly and couldn’t breathe.The patient has a history of diabetes, high cholesterol, and high blood pressure. The patient has no allergies to medications. The wife reports a 2 pack per day smoking history. His medications include a baby aspirin, atorvastatin, Glucophage, and atenolol. The patient's skin is pale and diaphoretic. There are no signs of trauma, and the patient obeys motor commands. The patient can only speak 2-3 word sentences and has moderate accessory muscle use. Eyes are open, pupils are 5mm and reactive to light. The vital signs are BP 78/42, P 226, R 36, SpO2 88% on room air, and T 98F (37C). The blood glucose is 120. The EtCO2 is 38. On further exam you note the patient has bilateral fine basilar crackles.

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