Mr. Roger Magdalo is a 52-year-old man who lives in a rural area with his family. He is an automotive repair man. However, he recently lost his job. He is the primary source of income for his family of six. Recently, he was playing basketball with his eldest son and developed substernal chest pressure. It was a little worrisome, but he thought it was just "heartburn" so he continued playing. After another 15 minutes, the chest pressure became worse. He also noticed that his left arm was numb. At that time his son mentioned that his color was pale and also noticed that he was sweating a lot. He called the paramedics at 11:50 am. However, because they live in a rural area, the emergency medical responders stated that an estimated time of arrival was 30 minutes to the home and 30 minutes to the closest hospital. The closest hospital was not equipped for invasive cardiac procedures. The hospital that could provide cardiovascular procedures was 2 hours away.
Past medical history: None. "I am fine so I just don't go see a doctor. I haven't had a reason to."
Cardiac risk factors:
· Family history; father died at age of 48 from cardiovascular disease
· Smoker; quit a few years ago
· Size 42 waist pants
Medications: None
Allergies: None
Fibrinolytic Checklist:
· Denies central nervous system disease
· Denies closed head or facial trauma
· No recent surgery
GUIDE QUESTIONS:
Past medical history: None. "I am fine so I just don't go see a doctor. I haven't had a reason to."
Cardiac risk factors:
· Family history; father died at age of 48 from cardiovascular disease
· Smoker; quit a few years ago
· Size 42 waist pants
Medications: None
Allergies: None
Fibrinolytic Checklist:
· Denies central nervous system disease
· Denies closed head or facial trauma
· No recent surgery
GUIDE QUESTIONS:
- If you were the son, what could you have done?
- What is the best solution to this case granting that the nearest hospital is two hours away?
- Looking at the risk factors, what could have contributed to the scenario?