Chest pain: it's our bread and butter in the ED, and it’s similarly a fairly straightforward EMS protocol. Providers at the CFR level can give chewable aspirin, while EMTs can assist with administering a patient’s own, previously prescribed nitro. Paramedics can independently give nitro if appropriate, but crucially, they’ll be the ones to perform and interpret the 12-lead EKG to answer the ever-important question: “STEMI or no STEMI?” Once again I’m attaching the specialty center appendix to show which NYC hospitals are currently equipped to receive STEMIs. For those of us answering the OLMC phone, the most important thing we will often be providing to these jobs is our own interpretation of the EKG (either via an emailed copy or, sometimes, just a verbal report), as well as guidance as to whether or not crews should divert from the nearest hospital to go to a STEMI center, instead.
I hope you all have been appreciating these emails as of late, I really do put a lot of…heart…into them? ha ha you’re all welcome www.nycremsco.org and the protocol binder for more.
Dave