A recent commenter posted that this lull I'm having was just the calm before the storm. Well, if the length of the calm has anything to do with the severity of the storm, I'm in for it. For the past several shifts, I have done almost nothing. A few routine transfers, fire stand-by's and one chest pain.
But that one I could do absolutely nothing for. She had major peripheral edema, but her lungs were clear. She has so much edema and her extremities were so swollen, that despite me and my partners repeated attempts, we could not get an IV in place. She had substernal chest pain that radiated to her back and to her left arm. the monitor showed A-fib, a new onset as far as we could tell, with a few PVC's thrown in to boot, other than that her 12-lead was OK. We had her on O2, but that was pretty much the extent of our treatment. She already had her aspirin about 2 hours before our arrival, so that was out. With our protocols, we can not give nitro without an IV in place, so that was out as well.
She made it to the ED, not sure how she fared there, but I hope that she's OK. I wish I could have done more for her pain. I felt pretty useless just sitting there holding her hand all the way to the hospital. Everyone said that I did OK, there was nothing else I could do. But they didn't have to see the pain in her eyes for 35 minutes.