...I was on the flight to SF yesterday, and stopped to think about that 56 y/o gentleman that came into the pediatric E.R., having a heart attack. Funny how things never turn out or seem to go the way we want them sometime...analyzing or just thinking about the entire ocurrence, it was interesting to note that nothing went the way we wanted it too. It usually doesn't.
Standard practice with a chest painer...well... lets see....oxygen, heart monitor, EKG, IV...x2 if possible, medication for pain (to help dilate the vessels and prevent an infarct somewhere), blood work, etc...
first problem: no IV access...and I don't mean we didn't see anything, it was that and the fact that he'd been stripped of some crucial veins for his last heart attack. : great! a couple sticks later, and one of the girls got a 22gauge IV in his hand.
After thinking about it...I thought to myself, maybe this was the best location for him to end up in....a Pediatric E.R. where we specialize in hitting small veins on babies. Lucky for him.
2nd problem, he couldn't take nitro pills (pretty standard for chest pain) shit.
3rd problem...Morphine is a good alternative, it helps with the pain, and also dilates the vessels....he tells us he has a bad reaction to it. well, shit!
Dilaudid it is.
The doc who took care of him, also works at the adult E.R., 2nd plus for him.
EMS arrived in short order, and I couldn't help but mutter under my breath a good luck to him, as I thought of my grandfather, and thinking this guy is alone in this city and his family is not here. I just wanted him to make it so that his family could see him before anything drastic happened. We transferred him out expeditiously to the adult e.r.
that is all.
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