The ED Gauntlet - A ring of sometimes irrelevant fire
Sitting in our station last night, the local cable channel showed a commercial of an unnamed, regional, academic medical center that is known for excellence in many specialties. We'll call it "Big Hospital X". I felt it was a good piece of marketing, liked the imagery, the aerial views of the facility, the smiling faces of the competent within. It was -- good marketing. In the middle of the night, we responded to a call for a person with chest pain who had consumed an enormous amount of nitroglycerine (NTG) as in more than five times the prescribed dose, and more importantly, without relief. Some of our most basic training informs us that chest pain that does not respond to nitroglycerine is less likely to be angina and more consistent with someone having a heart attack. Upon arrival we encounter a strong looking, hulk of a man in his early 60's seated at the dining room table. Long story short, he's had heart attacks in the past, has had coronary artery byp...