Gents,
Just to let you know, I'm still checking in from time to time on this thread. I haven't said anything, because I'm liking how you're working it out amongst yourselves.
With that being said, I will post up a couple of things I noticed ...
1) There was no chest trauma to this Pt. so you can r/o a pneumothorax (x-rays at the clinic confirmed this) but nice pick up on Beck's triad, a most probable sign of a pneumothorax.
2) The question of Ground v. Air. As the scenario is set up, the Pt. is at a clinic (ergo, very limited medical capabilities). There is a non PCI facility 15 min away and a PCI facility 45 min away. I think we all can agree this Pt. needs to get to a Cath lab ASAP. So the question(s) is/are .....
Do you call in air to the LZ set up by the local FD. Take into account, calling the air transport service. Spool up time for the AC. Flight time to the LZ. Load time at LZ. Flight time back to PCI.
Adel hopefully you can shed some light on these numbers.
There is also, transporting the Pt. to the non-PCI facility, and get the Pt. stable. They would at least have blood and any other type of fluid that would help get that B/P up. They would also have an LZ, so air could be called to that facility, but at least the Pt. would be in a higher level of care facility other than the clinic.
There is also the possibility just of loading and going via ground to the PCI.
Those are a couple of things I just wanted to throw out there.
