Man Calls 911 and Complains of Chest Pain After Cutting Out Own Pacemaker

This article is a rather interesting story that just points out why it’s not a good idea to do surgery on yourself.  EMS fire fighters we’re called to the group home where a man living their complained of chest pain went to his room while others called 911.  When EMS arrived the man was still complaining of chest pain but he soon became unconscious and at the back of the ambulance when they removed his shirt they found a stab wound in the upper chest and wondered what could have caused it.  They initially thought it might have been an assault but apparently it turns out the man had cut out and removed his own pacemaker.

I’m not sure why he did this.  It was misfiring and causing him pain but clearly he needed that pacemaker and he should have left it in there.  Probably he is in a group home, maybe he is mentally ill.  It doesn’t say in the article but certainly a very interesting thing.  The lesson learned here for the EMS professional out there is do a thorough assessment as quickly as possible.  Perhaps I’m not saying they would have definitely figured this out and saved this guy because I’m not second guessing this all.  I mean there’s no sign that there’s any foul play here or misdoing by the paramedics but the lesson I learned here is make sure we’re getting that full assessment if necessary for things that just don’t add up or don’t seem right.  Maybe there might have been some indication that there might have been something else going on here and maybe they could have seen some blood or something.  Again I’m not second guessing here I’m just kind of thinking all right how do I make this different?  What will I try to do if I can do this again if I was one of these paramedics?

This is one of those things you never know what you’re going to find.  You show up for a routine chest pain call at a group home you probably go to three or four times a week and it’s just a routine call maybe this is a guy who is a frequent flyer.  You never know but you can’t just walk in the door saying “Oh! It’s Joe’s chest pain again.”  because when you show up and Joe’s chest pain ends up being a chest stabbing even if it’s self-inflicted and he pulled his pacemaker out, you just never know what you going to find when you get that patient in the back of your unit and start doing your full assessment.  Always be prepared to step back and reassess.  If something doesn’t quite make sense, if that little nagging thought in the back of your head is saying “this isn’t right.  I need to think differently on this.”  Then think differently.  It’s like that old Apple ad Think Different.  Don’t be afraid to step back and you know it’s like back the car up to the intersection and make that turn you are supposed to make because you missed red the turn the first time.  It’s okay to do that that’s part of assessment.  It’s part of medicine.  It’s why we reassess patients but you know hey this just goes to show we can’t just assume that the call we get from the dispatcher is exactly what we think it is.  An elderly gentleman with chest pain could be anything.  This is clearly the case of it being anything.

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This article has been featured in the news segment of the MedicCast podcast episode Pain Management Champions and Episode 289.