Question

Simulation video.

CHRISTINE: Emergency Department, this is Christine.

WYATT: Hi, this is Wyatt, one of the emergency medical technicians. We’ll be arriving soon with a

Client, who’s experiencing chest pain. His name is Rodney Davis. He’s 54 and arriving per EMS

Transfer to the Emergency Department. His chest pains started at 16:55. His wife gave him three doses

of nitroglycerin when it started. In addition, she gave him 325 milligrams of aspirin at 17:15. He has a

peripheral IV access line, and we’re sending the EMS report to you now with vital signs and medical

history.

CHRISTINE: OK, I’ll review the report, and we’ll be ready when you get here.

CHRISTINE: Hi, Mr. Davis. I’m Christine. I’m your nurse. Are you still having chest pain or

tightness?

RODNEY: Yes. Feels like my chest is being squeezed right here. And it’s hard to breathe.

CHRISTINE: When did the discomfort start?

RODNEY: About 5:00. And it’s as intense, if not worse, and I feel dizzy, sick to my stomach.

MAGGIE: My husband takes nitroglycerin sometimes when he has chest pain, but this time, the pain

Just hasn’t gone away. And he does have a history of blocked arteries.

CHRISTINE: OK. I’m going to switch these lead wires to our to monitor your heart rate rhythm

While you’re here. So what were you doing when the pain started?

RODNEY: I was outside shoveling my driveway.

CHRISTINE: On a scale of zero to 10, with 10 being the highest level of pain, what are you feeling?

RODNEY: With this squeezing over my heart, I’d say an eight.

CHRISTINE: OK. The electrocardiogram tech is coming to perform a 12 lead ECG, which will help

determine if your in pain is it due to a heart attack. Then the provider will review the results. I’m going to go and check up on your orders, and I’m going to come back with something for your pain.

1- Identify three priorities noted during report and state an action plan for these priorities.

2-Share one clinical experience that remind you of this scenario with the peer you are replying too

Answer 1

1) The three priorities noted during report and action plan for these priorities are :-

- Extreme chest pain

Action plan - To find the cause behind chest pain and administer analgesics and other medications as per the ECG rhythm.

- Difficulty to breathe due to chest pain

Action plan - To provide a semi fowlers position , provision of a cardiac table , administration of oxygen as per the requirements and order.

- Anxiety of the patient and his wife due unresolving chest pain

Action plan - To reduce their anxiety and calm them down by making them understand the cause and what actions will be taken .

2) When i was oposted in Cardiac ICU at a night shift , one case from emergency department got shifted to ICU under me . It was the same scenario - a 65 year old male got shortnes of breath and acute chest pain at night after having his dinner . First of all the famiy members taught it as acidity ,but when it does not resolved with anti acidity agents ,they got him to the emergency , and after the assessment it was confirmed that he had a mild attack for which he got shifted to the ICU . Management for pain , shortness of breath , adminstration of cardiac medicatio etc were done.