Dispatch: 8:07 Chest Pain
On Scene: 8:14
At Patient: 8:15
66-year-old female with 3 out of 10 chest pain X 2 hours. Periodic chest pain for last week. Skin warm and dry. No prior heart hx.
Initial 3-lead strip: 8:16
Vitals, 02 by cannula. 324 ASA PO. Patient shirt removed, put in hospital gown
Initial 12-Lead: 8:19 (Watch V4 in particular, as well as V1-V3 over course of ECGs)
IV # 18 in left AC. 0.4 NTG SL
Depart Scene: 8:21
Hospital called for official STEMI Notification: 8:22
2nd 12-lead ECG: 8:22 (Note LP12 spitting out 12-leads every three minutes.
8:23 2nd NTG SL. 2nd IV # 18 in right AC
(In meantime hospital alerting cath lab team)
8:25 3rd 12-Lead ECG
8:26 Cath Lab team arrives in ED
8:28: 4th 12-Lead ECG Pain now up to a 5.
Begin preparing patient for quick exit from ambulance
8:31 5th 12-Lead ECG
8:34 Out at Hospital
8:35 Transfer Care to ED Doc/medical staff/ cath lab team
8:36 Hospital ECG
Next ten minutes Patient is prepped(additional drugs, procedure discussed, consent given) and then hustled upstairs.
8:50 Patient hits cath lab table.
9:08 Balloon inflated (Hospital Door to Balloon Time – 34 minutes).
Patient has 100% occlusion of Left Anterior Descending artery (The Widowmaker). Suffers arrhythmia. V-Tac. cardio-verted X 1. Then full reperfusion.
First there were hospitals, then ambulances, then emergency departments, then EMTs, then paramedics, then prehospital ECGs, and then STEMI alerts with cath lab notifications.