Enroute phaseScenario:The paramedic unit is dispatched to a…
Questions
Enrоute phаseScenаriо:The pаramedic unit is dispatched tо a residential care facility for an 82-year-old male who is experiencing difficulty breathing and is unable to lie flat. The call was received at 0915. Estimated response time is 6 minutes. The paramedic is partnered with an EMT, and a BLS fire engine crew is also responding. It is a cool fall morning, 48°F (9°C), with overcast skies and light traffic. According to staff on scene, the patient has a history of heart problems. They report the patient was doing well earlier in the day but became increasingly short of breath after breakfast and now appears pale and anxious.OnScene phaseScenario:The patient (approx. 75 kilograms) is found sitting upright in a recliner, visibly dyspneic and anxious. He is gasping for air, speaking in one- to two-word sentences, and using accessory muscles to breathe. Lung sounds are diminished with bilateral crackles. The patient has jugular vein distension and pitting edema in both lower extremities. He is pale and diaphoretic. Staff report that the patient missed his morning doses of furosemide and metoprolol. Initial vital signs: BP 178/96, HR 118 (irregular), RR 30, SpO₂ 86% on room air, Temp 97.6°F (36.4°C).Which ECG finding is most commonly associated with congestive heart failure in elderly patients and requires close monitoring due to its impact on cardiac output?