87 yom complaining of chest discomfort and dyspnea

 On a Thurday morning, approximately 02:15 hrs, in a small rural town, your EMS unit is dispatched to a residence for an 87 year old male with difficutly breathing.   You arrive on scene before the fire engine and enter the residence. Upon entering the bedroom, you find an elderly male, sitting on the edge of the bed, vomiting. He is alert and oriented x 4 (person, place, time, event) and with a GCS of 15. He appears to be in moderate respiratory distress, diaphoretic, with rapid and slightly labored breathing and muscle retraction, but yet, he's smiling at you and tries to explain what happened. He tells you, he woke up 15 minutes ago because he could not breath while laying down. Primary assessment: Patent airway Shallow and labored breathing with bilateral rales upon auscultation Weak and slightly irregular radial pulses Skin: cool to  touch, pale and diaphoretic with >2 sec. capillary refill time No signs of external bleeding  He is also complaining of chest discomfort throughout his entire chest, rated 7/10, non-radiating which started at the same time he woke up from his sleep. Nothing makes this discomfort better or worst. Past Medical Hystory: Hypertension (HTN) Hyperlipidemia Hypothyroidism Asthma Current medications: Amlodipine (Norvasc) Metoprolol (Lopressor) Levothyroxine (Syntrhoid) Atorvastatin (Lipitor) Albuterol Advair Daily vitamins No known allergies  Your partner places the patie...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 12 lead ecg CHF LBBB 12-Lead ECG chest discomfort dyspnea IVAN RIOS sgarbossa's criteria STEMI Source Type: research