What a great Friday night

Greetings all,
As Tracy commented in the earlier post the broadband has disappeared but I still have the back-up dial-up and I really need to talk about this job.
First some background. The following in an article I wrote about my first cardiac save here in NSW!

By George, we got him back!

The morning of Friday 1st December 2006 saw Paramedic Officer Pete Bouris and AO ‘Taz’ Rundle thinking about the hour or so before the end of their shift at Randwick when the call came in to Co-Ord at 0639 hrs of a 59 y/o male with chest pain.

The officers expedited to the address in Coogee and on arrival were met by the patient’s wife and directed inside the house to George. Initial scene survey showed that the vehicle could be parked in the driveway, but extrication from the house would be very difficult with an in-ground swimming pool taking up approximately 95% of the front yard.

On examination George was seated in a lounge room chair, he was alert, orientated, well perfused but visibly distressed. George stated the onset of a diffuse chest pain the previous evening that he relieved with self-administration of Nurofen. At 0530hrs this morning the pain returned with increased intensity, diaphoresis and radiating posteriorly to his back also superiorly to the right shoulder prompting the CDA to be called.

George’s baseline vitals were, Initial rhythm of Sinus Tachycardia,
Pulse – 100bpm, BP – 170/106, SaO2 – 99% on room air, GCS = 15.
PMHx – Hypertension, Glaucoma, Chest Infections and a problem with his platelets?? Unable to state what exactly!
Medications – Coversyl, Tilade, Nasonex and Lumigan Eye drops.

While vitals were being recorded, oxygen was administered by NRB at 15 lpm and the ZOLL M series defibrillator connected to monitor, it showed signs of possible ST elevation in leads 2 and 3. Because of the George’s unclear platelet problem (he believed his platelet count was low) Aspirin was contraindicated by medical reasons but GTN was commenced and George was transferred to the vehicle.

10 minutes after 1st contact with George and now in the back of the vehicle, the audible rhythm from the Zoll begins to change with multiple VEBs showing on the screen and a rapid decrease in George’s GCS with onset of VT (Torsade de pointes) and hypoxic seizure. A Code 2 was called to activate additional resources to our location while simultaneous insertion of an oral airway and the application of defibrillation pads allowed 1 x 150 joule DC shock delivered at 0659 hrs with the spontaneous return of Sinus Rhythm with VEB’s and a return to GCS = 15.
While George was recovering from the defibrillation our backup was cancelled due to ‘time till arrival’, George’s rapid improvement and the short distance to Prince of Wales Hospital.

A Code 3 was passed en route, urgent transport with George being cannulated with a 16G in the RCF. George was nauseous throughout with vitals on arrival at PoW being,
Alert, Pulse = 60, BP = 145sys, RR = 18 and GCS = 15. George was sitting up and conversing with staff during transfer to the hospital bed and remained stable up until we left.

A magnificent way to finish our shift, a textbook presentation, with all our protocols achieving a positive outcome.

Ps; Six months after the event I finally managed to catch George at home and discuss his case with him. Welcomed into their home again under much more pleasant circumstances George and his wife recounted their recollection of that morning and show me images of the coronary artery blockage that had a stent inserted the next day. Follow-up with his Cardiologist has shown no definable damage sustained to the heart and while George tells me that he has slowed down a little of his busy life, I think he is just more aware of the warning signs.

ps: During the presentation Stephen, Georges son came up to me and simple said 'thank you for giving me my dad back' that makes every bad job for a year blow away.



The article was printed with the picture here, (cut & paste the address).

http://www.thespectator.com.au/pdfs/071116/WSpectator_16-11-07_ALL.pdf


Check out page 7 in this edition of the local rag to see what they used!!!




This photo has been published and I do have George and Stephens approval to use

Be careful out there and I'll see you at the Big One.

Taz