If it walks and talks like a duck it is certainly a...

I have been covering a lot of shifts (42 hours worth I think) this week with no calls. I was on last night / this morning as a “significant other” from 2400-0600 and then this morning as a driver 0600-1200. It figures that the one call I get is as a driver…


1110 our tones go off: “----ville rescue, *AC ambulance, EMS call, XX North main street in ----ville. 45 year old male with chest pains”.

----ville is just at the edge of our district, and due to the farmers market going on it takes me a tad longer to get to the station than I would like. As I’m responding to the station I hear “*AC ambulance monitors be advised that rescue is on the scene reporting that your patient has chest pain radiating through his neck and arm and a history of two prior MIs”. Hmm, my pulse kicks up a bit more (I also wonder if “be advised” is redundant in this sentence…).

A medic and EMT are in the rig, with the rig running and out of the bay, as I swing into the station parking lot. I call us out of service ALS as the medic and EMT are in the back getting the monitor and IV set up. We respond quickly to the scene and make it there in 6 minutes (this is good time given the distance). Rescue has a fire-police guy waiting for us, having blocked traffic and done a great job of letting us safely get the rig into the house.

What do we find? A patient who is upright, conscious, good color and chatting up a storm. His stated symptoms are all consistent with an MI, but he doesn’t LOOK like he is in trouble. Realizing I am new at this game and have a lot to learn, I file away in my memory banks that a patient having an MI can look great [HINT #1].

IV, cardiac monitor, etc. Patient refuses nitro as he doesn’t like the way it makes him feel [HINT #2]. Patient telling jokes and smiling between grimaces [HINT #3]. We are on scene for 8 min and out the door making our best time to the hospital.

At the hospital we get the patient settled and are working on the paperwork, cleaning the rig, etc., when the doc comes out. To make long story short, not only was our patient not having an MI, but he has never had one in his life! Doc claims guy THINKS he has a heart condition but he does not.

Hmmmm. I know there is a lesson to be learned here, but I’m not sure what it is…