We're having a great shift, bouncing bases but yet to actually do a call, so we stopped for ice cream (for me) and coffee (for him). Rookie mistake. Just as we get back into the ambulance with our respective vices, we got a call, code 4 for chest pain in the sketchiest area of town. Alright, I guess my ice cream will have to wait, since I'm driving on this call.
We head up dark, dingy stairs to the second floor of an apartment building, into an equally dark and dingy apartment. The patient is lying on the couch, gray and sweaty, alternately rubbing his chest and his left shoulder. Hmm, that would be a clue.
Upon realizing that his pulse was no higher than 40 beats per minute and his blood pressure just as abysmal, I turn to the nearest firefighter while my partner leads the assessment. "Would you be able to grab our stair chair, please?" He looks at me, looks at the patient, then back to me, "Dontcha think he can walk?" "Um, no. Stair chair, please." He leaves and I brush off his comment, not realizing until later that I could've and should've torn him a new one. Once we get the monitor attached and run our 12-lead, we see that he is having a massive inferior MI, a type of heart attack that typically presents with low blood pressure and low pulse, both of which he has - to the extreme. The fire department is still milling around aimlessly, not realizing that this patient could literally keel over dead any freaking second. Once I pre-alert the cardiac hospital that we are bringing in a STEMI, they perk up considerably and become extremely helpful.
On scene for less than 15 minutes, which includes carrying him down the stairs, we book it to the hospital, taking a firefighter with us just in case he codes en route. As I drive lights and sirens through traffic, I periodically glance at my ice cream, losing integrity by the second and turning into warm soup. So sad to watch.
We take him right upstairs to the cath lab and the procedure to re-open his coronary artery is started. The doctor thanks us for doing a great job and confides that based on his presentation, he has a very long road to recovery ahead of him, if he makes it at all. At least he has a chance, my poor ice cream is long gone.