City of New Orleans, 9-1-1, what's the emergency?
Is he responding appropriately?
Did he have any flu-like symptoms prior to this?
OK, I'm sending the paramedics to help you now.
RADIO DISPATCHER: Alpha 3251, I have a 6-0, 6-0-year-old
male short of breath.
We're
We're going to a 60-year-old male who's short of breath,
difficulty speaking between breaths.
He says he does not have inhalers,
no evidence of coronavirus, which means
he probably has coronavirus.
We're just kind of throwing out different ideas
of what it could be.
We're thinking it could be CHF, it could be COVID.
So we're just kind of trying to prepare ourselves
for what we may find on-scene.
BRANDON: How are you doing, my friend?
Been short of breath for how long?
Since 2005?
Has the oxygen helped that they put you on?
No oxygen?
This right here is oxygen. Has this helped your breathing?
OK.
All right, my friend.
So we're going to get you outside, get you
on a stretcher, take you to our truck
and do a few more things in there, OK?
This patient has a pacemaker.
Automatically, anyone with a pacemaker,
we're always wondering if their shortness of breath
is caused by any sort of cardiac issue.
So COVID is still on the table, but it's
a lower differential diagnosis.
He's breathing awfully hard, isn't he?
Mm-hmm.
So listen.
We're going to try to get another blood pressure on you.
We want to try to give you some nitroglycerin.
I think that may help you breathe better.
HEATHER: The stuff's working.
It is working.
Hey, your pacemaker's working.
That's always a good thing.
I'm glad it ain't off right now.
HEATHER: Mm-hmm.
All right, my friend.
You said no chest pain, right?
Irritating how?
We got time.
Start explaining.
Is it like a pressure, like a tickling?
Like a pressure?
All right.
So I'm going to spray some nitro under your tongue, all right?
So do me a favor.
Open your mouth real wide, lift your tongue all the way up.
There we go.
Oftentimes, a breathing problem
is actually a heart problem.
And given this patient's history,
that's what I think is going on.
Now I want you to tell us if that makes you feel better.
Nitroglycerin allows the heart to work more efficiently.
All right, buddy, you'll feel a stick in your hand, OK?
Relax this arm.
We just want it to fall down. Let it fall.
Let it fall. There you go.
Got to relax.
You doing all right?
You can't breathe?
All right.
That ain't good.
OK.
I know.
Listen to me, OK?
Your pacer stopped, so we're going to pace you, OK?
Just relax.
Got to relax.
We're responding to a male complaining of shortness
of breath, and all of a sudden, his pacemaker
has stopped working.
So right now, he's at risk for his heart stopping completely.
I'm going to lean you forward.
We externally put the defibrillation pads
on him, because our monitor has a pacemaker setting.
How do you feel?
Talk to me.
We just gave him--
Might be better?
Hey, man, don't you let the damn pacemaker stop again.
Luckily, his pacemaker then starts to work again,
and we don't actually need to deliver
any sort of external electricity from our monitor.
How do you feel right now?
Better than when we first got here?
That spray of nitro helped, didn't it?
You know, that's one of those cases where we do everything
right, and then something bad happened in spite of everything
we did.
Did you see a light?
OK.
All right.
Good.
Don't let it.
This man's pacemaker has stopped working.
It's malfunctioning.
It's not firing all the time when it's supposed to.
It will intermittently stop, which is causing
him shortness of breath.
And once that pacemaker is replaced, all of his symptoms
should dissipate.
We thought we lost you.
Has that ever happened before?
Not like that.
Damn certain you need to see a doctor.
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