Guest guest Posted May 25, 2002 Report Share Posted May 25, 2002 based on that info alone..............Not! Don Tough one > Hello chaps, > > What do you do with a man presents with epigastric pain moving to chest, ECG > shows LBBB and first CK CKMB and tropinin T all negative.... Thromolyse or > not ????? > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > Post message: egroups > Subscribe: -subscribeegroups > Unsubscribe: -unsubscribeegroups > > Thank you for supporting Remote Medics Online. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2002 Report Share Posted May 25, 2002 Hi, Difficult one - would depend if there is any previous history of an MI (might have developed his LBBB then), or how long he has had pain for - it can take a few hours for cardiac enzymes to become positive. We have recently amended our pre-hosp thrombolysis protocols to incl LBBB. If it sounds like I am hedging my bets, it's because I am!! Cheers Anton In message <2DC0791EC041D21188D60008C72852221018BC77@...> " Brash, \\ Lines, Gavin (amed2) " <amed2@...> writes: > Hello chaps, > > What do you do with a man presents with epigastric pain moving to chest, ECG > shows LBBB and first CK CKMB and tropinin T all negative.... Thromolyse or > not ????? > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > Post message: egroups > Subscribe: -subscribeegroups > Unsubscribe: -unsubscribeegroups > > Thank you for supporting Remote Medics Online. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2002 Report Share Posted May 25, 2002 Chest pain, new onset LBBB= AMI Thrombolyse if no contraindications Edwin D.O. Emergency Physician Fla,USA Tough one > Hello chaps, > > What do you do with a man presents with epigastric pain moving to chest, ECG > shows LBBB and first CK CKMB and tropinin T all negative.... Thromolyse or > not ????? > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > Post message: egroups > Subscribe: -subscribeegroups > Unsubscribe: -unsubscribeegroups > > Thank you for supporting Remote Medics Online. > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 26, 2002 Report Share Posted May 26, 2002 Would want to know previous history, onset time of pain, overall appearence of patient. The blood work may not show anything for several hours. Does the paitent recive any relief from nitro etc;? Whats my transport time to the beach? Cheers Tom >From: " Brash, \\ Lines, Gavin (amed2) " <amed2@...> >Reply- > " ' ' " >< > >Subject: Tough one >Date: Sat, 25 May 2002 16:53:11 -0700 > >Hello chaps, > >What do you do with a man presents with epigastric pain moving to chest, >ECG >shows LBBB and first CK CKMB and tropinin T all negative.... Thromolyse or >not ????? > > > _________________________________________________________________ Chat with friends online, try MSN Messenger: http://messenger.msn.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 26, 2002 Report Share Posted May 26, 2002 Well.... Sorry for not replying earlier as I spent the day in Bed after staying up 24hrs with the guy ................. Luckily .. We decides to thromolise.... CK this morning 1120 CK MB way greater than 6%, Tropinin T positive.... We had no previous ECG's to judge by so went on clinical presentation. Wll there you go just goes to show don't wait for Enzymes ... " Minutes mean Myocardium " . . Brash Senior Nurse Supervisor International SOS \ Cabinda Gulf Oil Company e-mail: Amed2@... Telephone: CTN. 8 345 2696 Via Aberdeen 01224 334000 Cabinda Ext. 2696 > Re: Tough one > > based on that info alone..............Not! > > Don > > Tough one > > > > Hello chaps, > > > > What do you do with a man presents with epigastric pain moving to chest, > ECG > > shows LBBB and first CK CKMB and tropinin T all negative.... Thromolyse > or > > not ????? > > > > > > > > > > > > Member Information: > > > > List owner: Ian Sharpe Owner@... > > Editor: Ross Boardman Editor@... > > > > Post message: egroups > > Subscribe: -subscribeegroups > > Unsubscribe: -unsubscribeegroups > > > > Thank you for supporting Remote Medics Online. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2002 Report Share Posted May 27, 2002 Good call . Good to see. Did you have Telemedicine referal to CCU or was it you and the Doc? >From: " Brash, \\ Lines, Gavin (amed2) " <amed2@...> >Reply- > " ' ' " >< > >Subject: RE: Tough one >Date: Sun, 26 May 2002 12:20:13 -0700 > >Well.... Sorry for not replying earlier as I spent the day in Bed after >staying up 24hrs with the guy ................. Luckily .. We decides to >thromolise.... CK this morning 1120 CK MB way greater than 6%, Tropinin T >positive.... We had no previous ECG's to judge by so went on clinical >presentation. > >Wll there you go just goes to show don't wait for Enzymes ... " Minutes >mean >Myocardium " . > >. > > Brash >Senior Nurse Supervisor >International SOS \ Cabinda Gulf Oil Company >e-mail: Amed2@... >Telephone: CTN. 8 345 2696 >Via Aberdeen 01224 334000 Cabinda Ext. 2696 > > > Re: Tough one > > > > based on that info alone..............Not! > > > > Don > > > > Tough one > > > > > > > Hello chaps, > > > > > > What do you do with a man presents with epigastric pain moving to >chest, > > ECG > > > shows LBBB and first CK CKMB and tropinin T all negative.... >Thromolyse > > or > > > not ????? > > > > > > > > > > > > > > > > > > Member Information: > > > > > > List owner: Ian Sharpe Owner@... > > > Editor: Ross Boardman Editor@... > > > > > > Post message: egroups > > > Subscribe: -subscribeegroups > > > Unsubscribe: -unsubscribeegroups > > > > > > Thank you for supporting Remote Medics Online. > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 27, 2002 Report Share Posted May 27, 2002 Gordon, Doc and Myself.. Used to work CCU and ITU when an NHS slave.... > Re: Tough one > > > > > > based on that info alone..............Not! > > > > > > Don > > > > > > Tough one > > > > > > > > > > Hello chaps, > > > > > > > > What do you do with a man presents with epigastric pain moving to > >chest, > > > ECG > > > > shows LBBB and first CK CKMB and tropinin T all negative.... > >Thromolyse > > > or > > > > not ????? > > > > > > > > > > > > > > > > > > > > > > > > Member Information: > > > > > > > > List owner: Ian Sharpe Owner@... > > > > Editor: Ross Boardman Editor@... > > > > > > > > Post message: egroups > > > > Subscribe: -subscribeegroups > > > > Unsubscribe: -unsubscribeegroups > > > > > > > > Thank you for supporting Remote Medics Online. > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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