So,
I go to eval this 62yo African-American male who developed chest pain after bending forward to pick something up off the floor.
He presents generally well-looking, in mild distress, complaining of 4/10,dull,retro-sternal, non-radiating pain, with no other associated symptoms. He is A&Ox4,mildly freaked out but is easily re-directed verbally,no respiratory distress,lungs are clear with good tidal volume.He is slightly diaphoretic,but it's a warm day.No other nothing,, this is almost a bullshit chest pain call.
He only takes a weenie dose of Lisinopril but takes a hefty dose of Potassium (hint for later).
Anyway, 12 Lead in the bedroom shows a wee bit of elevation in his inferior leads, nothing else,, big whoop.
I go get the chair, my Partner gives him the asprin while I'm out and O's, bladitty bla.
I just unplug the monitor and leave him all hooked up for the carry out. He's fine, talking and jovial.
I get him out to the stoop, he says "guys I may get sick here" ,which raises my left eyebrow.
Well, as we load him in, he booches all over the place and goes unconscious.
We hook him back up to find him in VF. I slap the pads, whack him twice and returns to a sinusy-type deal.
My partner is looking for pulses and was doing the line,I just reached up and got the BVM & the ET kit. I attempt to pre-oxy him and he's blowing back against the mask. He's awake and talking. But not for long. He continued to drop into shockable rhythms,and out into being awake. I shock this guy...30 yes,thirty times in 18 minutes along with Amiodarone,Mag (cuz I'm sure it was Torsades at one point),fluid, but never needed compressions! We get him in, they shock him 15 more times, he was lucky to get on the cath table where they place a stent. I go back the next day,,he's awake and hugging me. They also found that he was wasting his K due to a teenie tumor on his adrenals. It was a perfect storm for him. He still flies his Piper Cherokee every other day. He's a cool guy.
Oh yeah, we share a birthday.
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