Inferior wall MI. leads 2, 3, aVf with reciprocal in V5, V6.
http://www.learntheheart.com/ecg-rev...on-mi-review-/
Fluids to get pressures up, then a pressor, neosynephrin, or dobutamine. (Neo doesn't tax the heart as much.)
i would have tried a fluid challenge except for the edema and crackles at the the base of lung.
Pain control- fentanyl because of pressures, then Morphine
call me conventional but I'd still go with MSO4 for the added benefit of smooth muscle relaxation. Even with the hypotension.
Fly to PCI center. He has either occluded inferior side OR re-occluded the stents.
agree
Since he is on Plavix already ensure that he is still taking it. (I have a guy here that stopped taking it for a month and re-occluded - yes it can happen that fast).
great point
May get to Nitro drip after fluids are way up (i know, controversial, but I may try to get him open after fluids.
Possibly, I'd opt for pressors though.
Not too concerned about labs as of yet, but am very concerned about keeping as much of his heart alive as possible. Huge amount of elevation in lead 2 and 3.
As a flight medic - I'd fly faster.
