brock8024 Posted January 9, 2008 Share Posted January 9, 2008 Ok so you and your partner are woke up at a nice 0400 for a 40 year old black female with chest pain. What you want to know? Link to comment Share on other sites More sharing options...
JPINFV Posted January 9, 2008 Share Posted January 9, 2008 Let's start this off simple. Is the responding unit ALS, BLS, or Scenario Section Super Squad (hospital in a moving box)? Distance to nearest hospital and hospital with cath lab? Location of snooze button. General impression (skin, weight, breathing quality, etc). Link to comment Share on other sites More sharing options...
brock8024 Posted January 9, 2008 Author Share Posted January 9, 2008 Let's start this off simple. Is the responding unit ALS, BLS, or Scenario Section Super Squad (hospital in a moving box)? Distance to nearest hospital and hospital with cath lab? Location of snooze button. General impression (skin, weight, breathing quality, etc). Responding unit is ALS 5 mins nearest ER and 45 with Cath I wish I could hit the Snooze 40 year old overweight black female. Skin dry,warm,pink. RR 24 non labored. Pt does not answer your questions. She looks at you then husband so he will talk to u. Link to comment Share on other sites More sharing options...
brock8024 Posted January 9, 2008 Author Share Posted January 9, 2008 come on guys and gals. this was actually a intersting case. Link to comment Share on other sites More sharing options...
mobey Posted January 9, 2008 Share Posted January 9, 2008 Is she unable to talk? Is she able to nod yes or no? Ask the husband what preceded this presentation? Link to comment Share on other sites More sharing options...
AnthonyM83 Posted January 9, 2008 Share Posted January 9, 2008 What does the husband say the main problem is? Onset? Is she able to follow commands? Can you establish if she's oriented through the husband? Pulse? Rate/Quality? BP? O2 Sat? Medical hx? Meds? Link to comment Share on other sites More sharing options...
brock8024 Posted January 9, 2008 Author Share Posted January 9, 2008 Pt is able to speak some just seems like she does not want too. Husband states that she woke him up with chest pain about 10 mins prior to calling EMS. Pt has a hx of HTN, stent placement, and abscess tooth a few days ago and is rx for that. Pt will answer with head nods and speaks some but seems like she is just wanting to be difficult. At first she just looks at you the points to husband but with some coaxing she will speak. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted January 9, 2008 Share Posted January 9, 2008 Well, guess we have to start doing our assessment through the husband (though at some point, I would interview here separate from the husband just to make sure everything is kosher). Start the workup: Pulse? BP? O2 Sat, 12-lead Through husband: OPQRST? Hx of same? SOB? N/V? Feeling sick? Recent stress? Abd/Back pain? (palpate) Compliance with meds? Specific meds? Allergies? Link to comment Share on other sites More sharing options...
brock8024 Posted January 10, 2008 Author Share Posted January 10, 2008 Well, guess we have to start doing our assessment through the husband (though at some point, I would interview here separate from the husband just to make sure everything is kosher). Start the workup: Pulse? BP? O2 Sat, 12-lead Through husband: OPQRST? Hx of same? SOB? N/V? Feeling sick? Recent stress? Abd/Back pain? (palpate) Compliance with meds? Specific meds? Allergies? HR-120 reg, 24 RR slightly labored, 93% RA, sinus tach on monitor. I work rural EMS so no 12 -lead til hospital. Chest pain woke her up. She states it is a 5 to 6 out of 10, after asking and head nods it is a sharp pain sometimes presure. IT radiates from substeranl to right side of chest and to back and up neck. When you palpate it hurts more. She has been fine jsut the abscess tooth. She takes her meds and has NKDA. she takes the above meds listed. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted January 10, 2008 Share Posted January 10, 2008 Lung sounds? BP? JVD? Pedal Edema? Recent injuries and physical strains? Does pain increase on respiration? O2 by NC, try to get a sat over 95%. Does it help? 162 ASA. IV w/ Hep-lock Link to comment Share on other sites More sharing options...
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