Author Archives: SWORBHP

Question: I am just wondering if ASA is contraindicated for patients taking Pradaxa?

Question: While enroute to the emergency department with a VSA patient, if your patient presents in shockable rhythm (either new, or still in a shockable rhythm), can we continue to shock the patient without pulling over? My understanding of the reason for stopping was because we used to use semi-automated systems, and we did not want false interpretations based on artifact. But, if we are now interpreting the rhythm, and determine that it is a shockable rhythm, not artifact while in transit, shouldn't we be shocking?

The OBHG companion document states to stop when enroute using semi-automated system, no wording on manual defibrillation.

Patient Presentation: 85 year old male had sudden onset shortness of breath and chest tightness while taking his dog out for a walk. The chest tightness is consistent with his usual angina discomfort but is far worse 9/10. PMHx: Angina, hypertension, CABG, hyperlipidemia. Meds: NitroDur patch, Altace, Lipitor, ASA.

What is YOUR interpretation?

Patient Presentation: 62 year old female states she feels ‘fine’ now, but family states she slipped off the couch while sitting. PMHx: Hypothyroidism, Hypertension. Meds: Altace, Synthroid.

What is YOUR interpretation?

Patient Presentation: 60 year old male had a syncopal episode while standing in church. PMHx: Hypertension, hyperlipidemia. Meds: Altace, Lipitor.

What is YOUR interpretation?

Patient Presentation: 60 year old male was hosting family for dinner, and had sudden onset dizziness and ‘feeling faint’ while putting the dishes away. PMHx: Hypertension. Meds: Metoprolol, ASA.

What is YOUR interpretation?

Patient Presentation: 40 year old female has sudden onset diaphoresis, nausea and weakness. She has slight discomfort in the left shoulder and upper back. PMHx: Stressful home/work life, but otherwise healthy. Meds: None.

What is YOUR interpretation?

Patient Presentation: 66 year old male has sudden onset chest heaviness and shortness of breath while getting ready for bed. PMHx: Smoker, hasn’t been to a doctor in years. Meds: None.

What is YOUR interpretation?

Patient Presentation: 49 year old male has sudden onset tightness in the middle of the chest after eating dinner. He thinks it might be heartburn. Discomfort is non-radiating and non-reproducible and there is no past medical history/medication use.

What is YOUR interpretation?

Patient Presentation: 80 year old male has sudden onset chest heaviness and mild shortness of breath while walking two flights of stairs. PMHx: Angina, hypertension, hyperlipidemia, NIDDM. Meds: Nitroglycerin, Metoprolol, Lipitor, ASA, Glucophage.

What is YOUR interpretation?

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