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My dad could still be alive, but he's not

(www.jenn.site)
367 points DustinEchoes | 3 comments | 13 Nov 25 02:17 UTC | HN request time: 0.639s | source
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captainkrtek ◴[13 Nov 25 02:49 UTC] No.45909911[source]▶
My condolences, very sorry for your loss.

I work as an EMT (911) and resourcing is certainly a problem. In my small city, our response time is around 5 minutes, and if we need to upgrade to get paramedics, that’s maybe another 5-10.

However, if we are out on a call, out of service, or the neighboring city is on a call, now the next closest unit is 15+ minutes away.. sometimes there can just be bad luck in that nearby units are already out on multiple calls that came in around the same time, making the next closest response much further.

for a heart attack or unstable angina, the most an EMT will do (for our protocols) is recognize the likely heart attack, call for paramedics to perform an EKG to confirm the MI, administer 4 baby aspirin to be chewed and/or nitro (rx only), and monitor closely in case it becomes a cardiac arrest. If medics are far away we will probably head immediately to a hospital with a catheterization lab, or rendezvous with medics for them to takeover transport.

The few goals though:

- recognition (it could also be something equally bad/worse like an aortic aneurysm).

- aspirin to break any clots, assist administering nitro if prescribed.

- getting to a cath lab.

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prmph ◴[13 Nov 25 03:11 UTC] No.45910080[source]▶
Is it recommended to take or give aspirin ASAP before the EMTs arrive? If so, I wonder if the dad took it.
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laszlojamf ◴[13 Nov 25 04:06 UTC] No.45910500[source]▶
Apparently it's no longer recommended, since it could also be an aortic rupture, and aspirin would make it worse. https://www.health.harvard.edu/heart-health/should-i-take-an...
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1. captainkrtek ◴[13 Nov 25 04:14 UTC] No.45910549[source]▶
Depends on protocols, but hence why EMS’ job is recognition of the right issue (the best we can do), there are things we can evaluate to determine if we think its an aortic aneurysm even at the emt level to rule that out before making the determination to give aspirin (eg: comparing bilateral blood pressures, checking for pulsating masses)

a heart attack is far more common than an aortic aneurysm.

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2. laszlojamf ◴[13 Nov 25 04:42 UTC] No.45910730[source]▶
would comparing bilateral blood pressure (which I assume the patient could do themselves) be enough? I'm not asking for medical advice, just like... what would _you_ do if it was you who had sudden chest pain?
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3. captainkrtek ◴[13 Nov 25 05:01 UTC] No.45910869[source]▶
Id encourage you (generally, outside of hn) to lookup the symptoms of a heart attack and aortic aneurysm.

A aortic aneurysm can present with a pulsating mass in the abdomen, and is more common in older people and smokers. The inner lumen of the aorta starts to separate and blood can flow differently or be restricted, eg: right arm bp may be different than left arm. But absence of that doesn’t rule it out entirely.

Whereas a heart attack is going to feel pain in the chest, perhaps radiating to the jaw, shoulder, back, maybe nausea, sweating, and an impending sense of doom.

Automated bp cuffs are pretty inaccurate imo, we use them at the tail end of transport to the hospital and they usually spit out wild numbers. An auscultated bp with a stethoscope and sphygmomanometer is the gold standard.

Bottom line, If you are having chest pain, call 911.