Cardiac Bus, that's what we were!

Not bashing the Intensive Care Paramedics system but, the old way of keeping them for 'The Big One' means that general duties crews get to be first on scene and treat some very sick people and such has been our shifts.

One night it seemed that every patient either;
Has a pacemaker without a problem,
Has a pacemaker that has a problem,
Needs a pacemaker.

Best capture was of a patient under investigation for ???Syncope.
Suspects are prolonged QT interval, 1st degree heart block.

Healthy person, no other history.

Zoll Defib - three lead, no diagnostic capacity does show what would be a long interval by being more that half of the R-R interval but only just.

Everything else looks good,real good but you can stay on the monitor and we'll wheel you out anyway.
Totally uneventful journey, triage and that bed over there will be free in???? 20 minutes or so.

Patient states 'Oh,oh not feeling well' then like some slow m o t i o n action from the Matrix or something,

Observe a changing ECG,
Press the record button,
Lower the patient to supine on the stretcher,
Watch the rhythm drop to 18, (still recording)
In a controlled voice that penetrates three feet of concrete and all other consuming thoughts of the staff I ask for assistance (learnt that as a Drum Major when I needed to tell you how uncoordinated you were and your parentage),

Four Doctors decide my patient is much more interesting than theirs and we go straight to a Resus Bed and I'm still recording the whole event. The patients been wearing a twenty four hour halter with diddly squat showing up.

Sinus Arrest or SA exit block which ever, but patient had a return of sinus rhythm after two asystole periods of five and seven odd seconds.

Went to Cath Lab for a temp pacer and my job ends there.

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

Taz