this was a couple years back. i was working a shift with SA and we were in line to get breakfast at Bojangles and a 10D, chest pain, came out and we both got out of line and set off to it. usually when interrupted from breakfast a crew may make snarky remarks about the pt we are going to (of course, once on scene that all goes away) but this time i remember we didn't say anything we just took off. we got on scene and the first responders were already there with the pt. this was in a bad area of town on one of our worst streets for drugs and violence. we walked into the house and the pt was a black male about 42 years old, he looked younger. he was wild eyed and clutching frequently at his chest. right away we could tell there was something going on and we placed him on the stretcher. as we were pulling the stretcher out of his house, he was only 2-3 minutes from the hospital and we decided to do everything in the truck, he said something about "spiders". his house was dirty and i started to look at my shoulders and arms and get that feeling like stuff was crawling all over me. as we loaded him into the ambulance he said it again "is it the spider?" and i crawled into the truck looking at my clothes for spiders. SA placed him on the monitor and right away, i think without even a 12-Lead she just said "let's go, i'll do everything en route". the pt was very anxious and had that text book "impending sense of doom" going on, looking back in hindsight. i took off for the hospital and i could hear him asking SA "is it the spider" and finally she asked him what he was meaning. he started to say he was watching a hospital-type show the other night and heard about a spider. SA asked him "you mean a widow maker?" and he goes "yeah, that. is it that?" and i just mashed the pedal a little further into the floor. as i pulled up on the ramp of the old ED i could see SA in the rear view mirror start yelling at the guy and she pulled the head of the stretcher down, moving him from sitting to supine. i ran around to the back and pulled open the doors and jumped up and the pt looked to be having a seizure. SA was at the monitor and she had placed the pads on him earlier and the monitor was showing V-tach. but the pt was shaking so violently i told her to hold on and i checked for a pulse quickly and after 5-10 seconds of not finding one she gave him a nice shock at 200J. as i was pulling him out someone came out and i yelled to them to tell the ED our pt coded on the ramp. we ran him in and i was doing CPR and SA was pushing the stretcher and we got him into the old orange zone and the nurses and MD were there and i moved around to lower the head of the stretcher and the doc yelled out shock him again. the monitor was in between the pt's legs and the doc could see the V-tach plain as day once i stopped doing compressions. BAM! we hit him again and began to move him to the bed. within a minute of his first shock on the ramp the pt was shocked a second time and he was on the hospital bed, biting a female ED tech in the hand and screaming "i'm dreaming!!! i'm dreaming!!!". hell yeah he was dreaming. and sure enough he WAS having a widow maker. we later found out he had an extensive cardiac history from abusing cocaine and had had a mild MI in the past. "i'm dreaming!!! i'm dreaming!!!" crazy town.
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