[Trapper John]

As I said before, cardiac cases scare the crap out of me - too many ways to screw up and only one way to get it right. Supportive care and transport is the priority here. This patients ECG is a mess and no time to interpret. I'm thinking pulmonary embolism and possible CHF. Elevate the patient, start IV (NS drip 10 gtt/min). O2 by mask 15L/min, morphine 5 mg IV, 80 mg lasix as Nurse Tim said. Not sure about rotating tourniquets (that's a new one on me, so NT would you educate me?). The pO2 at 92% concerns me - possible respiratory acidosis if this has been going on for awhile. I would push an amp of bicarb. Transport to the nearest primary care facility (15 min by ground). This one is going to need a dDx by a cardiologist. I will try to decipher the ECG and post my dDx and Rx plan later. The primary goal at the moment is respiratory support and get him to the nearest primary care facility.