Any patient with a recent onset of chest pain, especially when the symptoms are ongoing, who may be potentially unstable based upon history, appearance, or vital signs, should be transported immediately to an emergency department preferably in an ambulance equipped with a defibrillator.
Full Answer
Any patient with a recent onset of chest pain, especially when the symptoms are ongoing, who may be potentially unstable based upon history, appearance, or vital signs, should be transported immediately to an emergency department preferably in an ambulance equipped with a defibrillator.
After resuscitation, if indicated, IV access, oxygen supplementation, and telemetry monitoring should be initiated. All patients with a complaint of “chest pain” should have an ECG in a time critical fashion (initiated triage). Initial management should be geared towards identifying the etiology of the chest pain complaint.
All patients with a complaint of “chest pain” should have an ECG in a time critical fashion (initiated triage). Initial management should be geared towards identifying the etiology of the chest pain complaint. B. Physical Examination Tips to Guide Management.
Chest Pain. While the priority in any patient who presents with chest pain is to exclude catastrophic or life threatening (cardiac) causes, non-life-threatening etiologies, which may be functionally disabling, are much more common in the primary care setting and require a cost-effective approach to diagnosis.
Medications, such as nitroglycerin, aspirin, and clot-busting drugs. Oxygen. Cardiac catheterization, which involves threading a flexible tube into the heart from a blood vessel in the wrist or groin to open a blocked artery.
If you or someone else may be having a heart attack, follow these first-aid steps:Call 911 or emergency medical assistance. ... Chew aspirin. ... Take nitroglycerin, if prescribed. ... Begin CPR on the person having a heart attack.More items...
Aspirin may be prescribed (if not contraindicated) in the setting of chest pain to reduce the risk of thrombus formation in blood vessels. Aspirin inhibits the formation of thromboxanes, which mediate vasoconstriction and platelet aggregation. Often, in the setting of chest pain, morphine will be prescribed.
Nursing ManagementManage chest pain.Bed rest.Provide oxygen.Administer aspirin and nitroglycerin.Place patient with head of the bed elevated at 45 degrees.Make patient comfortable.Hook up to monitor.Check vitals.More items...•
Determining the cause of chest pain depends on the patient's history and objective data from the physical exam and diagnostic tests. The most important diagnostic tool when evaluating chest pain is the ECG.
You should also visit the ER if your chest pain is prolonged, severe or accompanied by any of the following symptoms: Confusion/disorientation. Difficulty breathing/shortness of breath—especially after a long period of inactivity. Excessive sweating or ashen color.
The immediate concerns for a patient with suspected myocardial infarction should be their safety and comfort. Intravenous access must be available for effective administration of emergency drug therapy followed by rapid transfer to an area with a high level of supervision and resuscitation facilities.
Nursing Interventions Administer oxygen along with medication therapy to assist with relief of symptoms. Encourage bed rest with the back rest elevated to help decrease chest discomfort and dyspnea. Encourage changing of positions frequently to help keep fluid from pooling in the bases of the lungs.
Nursing InterventionsTreating angina. The nurse should instruct the patient to stop all activities and sit or rest in bed in a semi-Fowler's position when they experience angina, and administer nitroglycerin sublingually.Reducing anxiety. ... Preventing pain. ... Decreasing oxygen demand.
Other possible tests include a chest x-ray to look for alternative causes of chest discomfort, such as pneumonia or heart failure. A doctor also might give you a trial of medication to see whether it relieves your symptoms, and additional ECGs may be performed over time.
Image: Thinkstock. Every 43 seconds, someone in the United States has a heart attack. If one day that someone is you or a loved one, it may be helpful to know what's likely to happen, both en route to the hospital and after you arrive. For starters, always call 911 to be transported via ambulance rather than going by car.
The other reason to travel via ambulance is that in many places in the United States, if a person calls 911 complaining of chest pain, the dispatcher will send paramedics who are trained to perform an electrocardiogram (ECG). This simple, painless test records your heart's electrical activity through 12 small electrodes placed on your chest, arms, ...
Here's a rundown of the likely chain of events after you call 911. For a suspected heart attack , paramedics can often perform initial testing in the ambulance while the patient is en route to the hospital. Image: Thinkstock. Every 43 seconds, someone in the United States has a heart attack. If one day that someone is you or a loved one, it may be ...
Contrary to what you might assume, speed isn't the only rationale. "If you're having a heart attack, there are two reasons why you want to be in an ambulance," says Dr. Joshua Kosowsky, assistant professor of emergency medicine at Harvard Medical School. One is that in the unlikely event of cardiac arrest, the ambulance has ...
An imaging test may also be performed to quantify the degree of blood flow to the heart. One option is an echocardiogram, a noninvasive test that involves placing an ultrasound probe on your chest to create a moving image of your beating heart.
One is that in the unlikely event of cardiac arrest, the ambulance has the equipment and trained personnel to restart your heart. Cardiac arrest, which results from an electrical malfunction that stops the heart's pumping ability, is fatal without prompt treatment.
Chest pain is the second most common complaint in emergency departments, behind abdominal pain. One recent estimate put the number of visits at 6-8 million per year.
An ECG is the only mandatory test related to chest pain. Other testing is directed from the patient’s history, physical examination and risk factors. Such tests may include a CBC, basic or comprehensive metabolic panel and chest x-ray. The troponin test has become the standard for assessment of acute coronary syndromes.
Admission of chest pain patients varies at each facility. Each patient should have some form of risk stratification of their cardiac risk performed. Generally, many patients are admitted. There is a push, however, to discharge low risk patients home from the ED.
A 54 year-old man came to the ED complaining of indigestion. Upon presentation, he was symptom free. He had only a couple of cardiac risk factors. His initial ECG and labs were unremarkable. He had another episode of pain in the ED and a repeat ECG showed a subtle change. This prompted admission. The next morning, his ECG was dramatically worse.
My department does not currently have anything new or innovative. However, it will be interesting to see how things change since the FDA recently approved the “high-sensitivity troponin assay” for use in the USA.
It doesn’t take much to keep a heart healthy. Not smoking is a big part. The recommendations for low fat diets is coming under scrutiny, so it all comes back to moderation. Also, physical activity is huge. The current recommendations are to get 30-minutes of exercise on most days.
Emergency physicians run tests to rule out a heart attack or unstable angina, a serious condition in which the heart doesn’t get enough blood flow. These tests miss about 1.5 percent of cases, and they don’t do a good job at predicting whether a patient will experience a serious heart problem in the coming weeks.
Helping Patients with Chest Pain Make Decisions in the ER. Emergency physicians often recommend—or urge— monitoring and further testing when they see patients with chest pain, even if they haven’t had a heart attack. A study shows benefits of patients’ and doctors’ using a decision aid to guide next steps.
Any patient with a recent onset of chest pain, especially when the symptoms are ongoing, who may be potentially unstable based upon history, appearance, or vital signs, should be transported immediately to an emergency department preferably in an ambulance equipped with a defibrillator.
While the priority in any patient who presents with chest pain is to exclude catastrophic or life-threatening (cardiac) causes, non-life-threatening etiologies, which may be functionally disabling, are much more common in the primary care setting and require a cost-effective approach to diagnosis. The correct diagnosis is most often derived from a detailed history that is supported by specific physical findings, an electrocardiogram, and/or chest x-ray.
Numerous medical conditions can cause pain in the chest, some of these conditions are minor (e.g., anxiety); whereas, others are serious (e.g., heart attack).
If you or someone you love needs emergency medical care, you may debate whether to call for an ambulance or just drive yourself. There are certain instances when you should never drive yourself to the emergency room: Two such instances are if you have heart attack or stroke symptoms.
These are just guidelines; therefore, whenever in doubt, the adage “better safe than sorry” should be followed.
The symptoms associated with a heart attack and stroke are many and, in the event that you or a loved one is experiencing one of these life-threatening conditions, those symptoms could arise at any time.