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Old 11-18-2013, 21:29   #18
Trapper John
Quiet Professional
 
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Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,835
Quote:
Originally Posted by adal View Post
Inferior wall MI. leads 2, 3, aVf with reciprocal in V5, V6.
http://www.learntheheart.com/ecg-rev...on-mi-review-/

Fluids to get pressures up, then a pressor, neosynephrin, or dobutamine. (Neo doesn't tax the heart as much.)

Pain control- fentanyl because of pressures, then Morphine

Fly to PCI center. He has either occluded inferior side OR re-occluded the stents.

Since he is on Plavix already ensure that he is still taking it. (I have a guy here that stopped taking it for a month and re-occluded - yes it can happen that fast).

May get to Nitro drip after fluids are way up (i know, controversial, but I may try to get him open after fluids.

Not too concerned about labs as of yet, but am very concerned about keeping as much of his heart alive as possible. Huge amount of elevation in lead 2 and 3.

As a flight medic - I'd fly faster.
Really good assessment there Bro. I was struggling with MI vs BBB and in particular RBBB (M shaped QRS and wide or notched R wave in V1-V2).

It's nice to come out of the lab once in awhile and get exposed to some real medicine. I really appreciate the opportunity to see just how far out my wheelhouse this really is.

Still learning
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