EMS (with physician on board) is dispatched to a 42-year-old male with a chief complaint of chest pain and “possible heart attack.”
The patient is found lying on the couch. He appears to be reasonably comfortable and indicates that “the pain has eased a bit” since EMS was contacted.
Ventricular Fibrillation is considered the most favorable cardiac arrest rhythm, and if treated promptly can result in ROSC with a favorable neurological outcome. Most survival rates are reported using witnessed arrest with a shockable rhythm as opposed to asystole or PEA, as the outcomes of these rhythms are comparatively very poor.
When trying to decide on a subject for this blog post, I remembered an article I read a few months ago originally published in the Journal of Paramedic Practice, by Logarajah and Alinier titled ‘An Integrated ABCDE Approach To Managing Medical Emergencies Using CRM Principles’.
EMS is dispatched to a private residence for 70-year-old female who is believed to be unconscious.
On arrival, the patient is found lying in bed unresponsive to painful stimuli. The patient’s skin is pale and clammy. Her shirt is damp. Snoring respirations are noted and a slow carotid pulse is present.
