Further Assessment

Further assessment of the patient was carried out by the emergency department physician. They confirmed the history taken by the paramedics. They also confirmed the paramedic’s physical examination. The patient’s repeat blood pressure was 100/70 mmHg and he appeared stable. Finally, they confirmed the paramedic’s ECG diagnosis of acute inferior infarction and pointed out to the paramedics that initial symptoms of nausea and epigastric discomfort are common in these patients.

The paramedics initially treated the patient with supplemental oxygen. After determining he had no aspirin allergy, chewable aspirin was given. They withheld nitroglycerin and morphine sulfate because his initial blood pressure was 90/60 mmHg. While the patient was clinically stable in the emergency department, his pain persisted. He remained stable with a blood pressure of 90/60 mmHg and heart rate of fifty, and a small dose of intravenous morphine resulted in complete relief of his pain. Oxygen therapy was continued and assessed by pulse oxymetry. No arterial puncture was done, as it is contraindicated in this setting.