Vital signs: Skin - cool & diaphoretic. BP - 120/78. P - 75 and regular. R - 18 lungs clear. BG - 130 mg / dl. SpO2 - 99% on room air. Temp 99.2 F
You place him on 6 lpm of Oxygen by NC and evaluate the EKG and reassess vitals - They are unchanged from the previous set. You place an IV saline lock, and prepare for transport.
Your interpretation of the EKG and your next step should be:
a) Septoanterolateral wall MI - Aspirin, nitro prn for pain or pressure, continuous cardiac monitoring, expeditious transport.
b) DMI - Withhold nitro until fluid loading of 500 cc NS is established, then nitro prn for pain.
c) Normal EKG - No additional treatment is warranted, transport to ED.
d) Posterior wall MI - Aspirin, Morphine for pain or pressure, Lidocaine 100 mg IV prophylactically and a 2 mg/min drip.
e) Patients EKG shows a LBBB so it can not be used to rule in AMI - Transport as fast as possible.
Updated: February 26, 1998