Joan is admitted to the emergency department after 5 hours crushing chest pain at rest.
Roll over clerk in sheet
| Why we do an ECG in 10 mins of presentation: | In accordance with SIGN and QIS standards to ensure timely treatment for patients presenting with Acute Chest Pain.
These changes are indicative of an acute event. They demonstrate the acute coronary syndrome event. It may be useful to review the coronary circulation in Module 1 to understand the relationship between ECG changes and the area of the heart being affected. |
| Why we do initial obs: | Baseline observations are obtained on presentation to assess clinical status and again at regular intervals to assess progress.
Joan’s observations give cause for concern because she is relatively tachycardiac and hypotensive. She is also tachypnoeic and her oxygen saturations are low. Patients who are anxious or who are in pain are frequently tachycardic but the combination of all these factors points to haemodynamic compromise in Joan’s case. |
| Rationale for Medication: | GTN Spray sublingual to dilate blood vessels and relieve pain Morphine intravenously if pain is not resolving Metoclopramide intravenously for nausea Oxygen therapy as required if saturations are low Aspirin and Clopidogrel are anti-platelets to thin the blood Fondaparinux is a Factor Xa inhibitor (anti-coagulant) |
Page last reviewed: 09 Jun 2020
