S—Nausea no vomiting A—Morphine M—NTG, Lisinopril, Insulin P—MI with stents placed, diabetes and HTN L—Breakfast 1 hr ago E—Taking a shower
The patient informs paramedics that his pain resolved prior to EMS arrival. He states that he does not want to go to the hospital because he knows they will keep him for 4 to 5 hours and it will turn out to be nothing.
A 12-lead ECG is captured.
The paramedics tell the patient that with his past medical history he should go to the hospital by ambulance for an evaluation. He adamantly refused treatment even with 3 paramedics explaining the possible consequences of refusing care.
Suddenly, the patient's chest pain returns. He appears diaphoretic.