Saving lives with BLS

We in EMS have heard numerous times that it's BLS (basic life support) before ALS (advanced life support), and I am sure we all know medics who forget that. For those of us who are medics, I am sure we have each been guilty of that before. There is always that line of how aggressive should I be. I'm not a believer of "aggressive medicine", I am a believer of "do what the patient needs done to get them to the hospital in the same or better condition". In this field though, it's what the medic is comfortable with, and as long as you are doing a good job, then go for it. Sometimes, the pt dictates what you can do. The following pt had horrible veins and in 3 attempts, I was able to get flashback each time, a valve would be in the way. So what is one to do. BLS BLS BLS

Yesterday I was working and ran a call on a 56yo F with chest pain x3 hours. Pt also had nausea, vomiting, dull mid sternum pain radiating to the left shoulder. Pt was cool and dry to the touch with no past cardiac history. RR 22 P 48 BP 146/88 This is what presented on the monitor

I placed her on O2, gave the 324 ASA and 1 dose of nitro spray. Kept the pt talking. She had no relief of pain from the nitro. She had one more round still with no relief. So what is one to do. BP wouldn't allow for another nitro. So you run another strip.

Pulse is now 68 with RR at 18. The pain had gone to a 6 and stated she was breathing easier. I told her that I guess the medicine was working the way it was suppose to. She said, "No, it's the fact you're telling me everything you're doing and it isn't a mystery as to what was going on. I'm not as scared as I was before." All I could think was WOW. Basic skills and being myself helped this woman feel better in the middle of a massive heart attack. Sometimes the best "aggressive" medicine it making it seem that you aren't being aggressive. While I would have preferred to have hit that IV and pushed Morphine, knowing that the pt made it to the hospital slightly better than when I first saw her, tells me i was somewhat successful.

She had a 17 minute door to cath lab time.She had her procedure done with two stints placed. 3 hours after dropping her off, my partner and I were in her cardiac recovery unit room. She introduced us to her family and said "These are my two ambulance drivers". She told her daughter, who is an RN at that hospital, that she never would have guessed she was having a heart attack because the two of us were so calm. Then hearing your pt tell you thank you after that is great. You want to talk about a rare thank you. That is one of the best I've ever had.

I also want to give props to my partner Brad. He also remained calm. He understood the need for a smooth drive, while at the same time the need for a fast transport. He did an excellent job. I don't think I told him that. So Brad, thank you. I'm happy anytime I see you assigned to my truck. I'm also happy anytime you mom calls me to come over to "have some company"