Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Why do people deny they are having heart attacks? NSFW language in video

 

Why is this NSFW (Not Safe For Work)? Because some of the language in the video is not appropriate for some workplaces.

Why have Keven Smith talk about a heart attack?

Because we generally do not get an opportunity to have the patient explain what they were thinking while they were having the heart attack. We have to negotiate with the patient to be able to assess the medical condition properly, but we don’t usually have the time to have an extended discussion about why the patient is not feeling cooperative.
 


 

When did he realize that his significant family history of heart disease was causing his problems? Apparently, not until after the words heart attack were used by EMS.

How can people try to deny that the chest pressure, difficulty breathing, diaphoresis, nausea, et cetera are not a heart attack? Because it is natural for our species to assume either of two extremes – that bad things happen to other people or that bad things always happen to me. We are not good at being reasonable.

I had a cardiologist as a patient. He had the same presentation.

I was able to show him 9 of the 12 leads (not the augmented leads, because we did not have a 12 lead capable monitor). He admitted that the ST segment elevation was consistent with an acute myocardial infarction. He refused to leave.

As a cardiologist, he could easily explain that he understood cardiology better than I do, and therefore did understand the gravity of the situation.

He was answering all questions appropriately.

He felt that he would ruin the event he was attending if he left in an ambulance. His shirt was covered with what had been the contents of his stomach an little earlier. Nobody suggested that he should stay at the event.

Some men you just can’t reach.

How do you get someone to accept reality, when he adamantly insist that his opinion is real and that the evidence is wrong?

We did not end up back at that location the rest of the night and nobody else was dispatched to that location, so it appears that he did not drop dead right away. Beyond that, I don’t know. Maybe he was smart enough to see a fellow cardiologist soon after. Maybe it was something other than a heart attack. If it was a heart attack, maybe it was minor.

.

Comments

  1. I had a lady, middle aged, in what the ED physician said afterwards was a “high second degree block.” I just called it a third degree. Then I had only 9 leads and no computer analysis, like you. I saw some elevation, slight and because she had a fairly rapid response, her VS were “normal.” But her agitation and anxiety was through the roof. Jedi mind tricks didn’t work, cajoling, begging, good medic/bad medic – none of it worked. Mind you, her husband was already convinced and beside himself. Finally, I had enough. Took hold of her shoulders, and not nicely yelled, “YOU’RE GOING TO DIE. And I don’t want to see it, sign here.” More of a sneer.

    That got her onto the cot. A week and a half later she stopped by the station; after Cath Lab and the requisite stents, she wanted to thank me and my partner. We spoke nicely to each other, almost friendly.

    • I am pretty sure that my partner, and some of the people at the event, tried the You’re going to die line.

      People ask me if they are going to die. I respond by asking them what time frame they want to know about, since everybody dies.

      Sometimes I tell them that they probably won’t die before me. None of them have asked me if I am suicidal, or if there is a bomb on the ambulance, or . . . , yet.

      .

Speak Your Mind