Scout, prepare to be briefly yelled at.
First, good job on recognizing the fact that you were, in fact, having a Real Medical Emergencytm. Good on ya for recognizing that the slight burning sensation was a little odd, and then once the elephant copped a squat on your pectorals, good on ya for not saying, "oh, it's just a little heartburn." It's quite likely that if you had taken such a course of action (as many men do) Mrs. Scout would be making funeral arrangements this morning, instead of trying to recover from your attempts to kill her while running red lights at high rates of speed on icy roads.
Seriously, I'm glad that you're (mostly) ok :). But now I'm gonna take off my friendly forum member hat, and put on my pissed-off EMT hat.
I'm not pissed off because you deprived a crew of a good run last night. Matter of fact, I'm sure they appreciated the ability to sleep. I'm not completely pissed off because you encouraged your wife to drive in a reckless manner (although that's part of it) that would put most drunk drivers to shame. I will agree that driving you to the hospital probably saved a little bit of time in getting you to the hospital. However, it did NOT save you time in getting your ticker taken care of. The days of Johnny and Roy on Squad 51 are long gone my friend. If you lived next door to the hospital, you might have saved time in getting your ticker worked on. However, short of the roto-rooter treatment you got, there's very few things that can be done in an Emergency Room that can't be done in the back of the ol' b'ambulance. Matter of fact, many jurisdictions now refer to a paramedic-staffed ambulance as an MICU. That would be Mobile Intensive Care Unit. While I'm not exactly familiar with what your ambulances carry, let me briefly tell you what would have happened in our jurisdiction.
The 911 call? That would have taken about 20 seconds to triage and dispatch. Yep. We would have gotten your address, your phone #, your age, and your chief complaint. Chest pain is a magical pair of words that gets everybody woken up about 20 seconds after the phone is answered. 2 minutes later, a fire engine and an ambulance are screaming their way your direction with lights, sirens, bells and whistles. 3-5 minutes later, 5 or 6 well trained people will come barging into your home, and the rest of the procedure will go pretty much exactly like what happened when you stumbled into the ER.
Now here's where the fun stuff starts. We will hook you up to a monitor. A paramedic will take about 5 seconds to look at the ekg and say, "yep, you've definitely got a messed-up-heart." Then the rodeo really takes off. We're gonna get you in a somewhat comfortable position, and 3 people will be attacking you all at once. One will put an oxygen mask on you and crank the flow all the way up. While that's happening, another will tell you to open your mouth, lift your tongue, and then give you a squirt of nitroglycerin right under your tongue. Those two things are gonna cause a couple of changes in your heart right away. Your heart is not gonna have to work as hard, because your blood is going to be 100% oxygenated instead of 92-95%. Trust me, that 5-8% makes a huge difference. Second, your blood vessels are gonna dilate. That makes it easier for the heart to pump blood, therefore further reducing the oxygen demand that those poor little oxygen starved cardiac muscle cells have. That's gonna slow down the speed at which your heart is actively dying. Meanwhile, another medic is getting an iv started, probably in the big vein on the inside of your elbow. That's a big vein, and he's gonna use a pretty good size IV catheter. It's gonna hurt a little, but you probably won't notice it over the pain in your chest that is right now, hopefully subsiding a little bit between the oxygen and the nitro. Sadly, you're going to start noticing a really pounding headache, and that's a side effect of the nitro. Don't worry, the headache won't kill you. The chest pain will. On your other arm, someone will be checking your blood pressure. If it's still above 100 systolic, we're gonna give you another nitro spray. You're also gonna get to chew up 4 baby aspirin. Again, this is to reduce the strain on your heart. Aspirin is a blood thinner, and if your blood is thinner, a) it will make your blood easier to pump, and b) some blood might be able to sneak past the blockage that caused this whole mess to start with. Finally, about 3-4 minutes after the medics got there, you're gonna get a little bit of morphine in that IV. Now, this is not so much to reduce the sensation of pain you're feeling. It actually helps to further dilate blood vessels and reduce cardiac workload. However, the reduction in pain sensation also helps to reduce anxiety, which also further reduces cardiac workload 'cause you quit dumping adrenaline into your system.
Now is when the cool stuff actually happens that is pretty new. We're gonna hook you up to a 12-lead ECG. This used to require huge, bulky machines at hospitals to accomplish. Now, our portable ECG machines can do the same thing. It's going to look at the electrical activity of your heart from 12 different angles. It's gonna crunch that for us, and give us a pretty good idea of what's happening in your heart. "Congratulations Scout, you're having a heart attack!" The even cooler part, is that we're then gonna transmit that ECG to the hospital. The interventional cardiologist is gonna take a look at that, and they're gonna have the Cath Lab all prepped and ready to go for your arrival. We're gonna run you code-3 to the hospital. Total time from calling 911 to transporting? Less than 10 minutes. 5 or so minutes later, we're gonna wheel you into the hospital. But we're not gonna stop in the ER. Nope. We're gonna take you directly up to that Cath Lab that's been prepped just for your arrival. And that means that you're getting the roto-rooter even sooner than if you'd had your wife drive you in.
What's the lesson here folks? If you're having a Real Medical Emergencytm, your loved one may be able to get you to the hospital quicker than waiting for us to drive you there. BUT, we can get you medical treatment much more quickly than driving yourself to the hospital.
