- Nurse: Tell me about your chest pain.
- Naveed: It started while I was watching the cricket 30 mins ago. I just feel terrible.
Note: speak to the patient directly and use an open question to allow the patient to tell their story
- Nurse: You sound as though you are breathless. Is this worse than normal for you?
- Naveed: Yes, I’m not normally like this.
Note: benchmark what is normal for the patient to allow you to assess new and emergent symptoms
- Nurse: Can you describe the pain?
- Naveed: It feels very tight across my chest.
Note: characteristics of the type of pain described in the patient’s own words this avoids “leading the patient”
- Nurse: Does the pain go anywhere else?
- Naveed: My arm feels heavy too.
Note: radiation of pain is a significant symptom in cardiac chest pain and would be red flag for the nurse
- Nurse: Do you feel cold or clammy?
- Naveed: I feel a little sick.
Note: recognition of associated red flag symptoms are crucial to ensure a full clinical picture is obtained nausea is often experienced by patients due to vagal nerve stimulation
Pulse point
Symptoms may not always sound typical. Patients may find it hard to describe symptoms and may not always have English as their first language. A high level of suspicion is needed in cases of telephone triage so that serious problems are not missed.
Nurses in NHS 24 have access to electronic decision making software to support or challenge their clinical decisions, they are required to complete mandatory e-learning modules each year including chest pain.
Page last reviewed: 11 Jun 2020
