Emergency Dept Case StudiesEmergency Dept Case StudiesChest Pain

Mr. G is a 51 yo male with a history of MI, CAD. Patient is c/o substernal chest pain, left arm pain. Wife drove patient to hospital.

What are your immediate priorities for this patient?

 ABC: VS, O2, EKG IV, Monitor, ASA (check with MD first),

Present EKG to ED attending

EKG shows ST elevations V1-V6 “tombstones” VS are 110/80.104.24. temp 98.5 po and the patient still has chest pain.

How do you proceed?

SL NTG, prepare for nitro and heparin drips.

Consider placing 2nd IV.

Physician may order lopressor

Anticipate cardiology eval and possible cath lab

Ensure that lab studies including coags, cks, chemistries, CBC have been sent. Portable chest x-ray should be completed.

Further assessment- CV, Resp, Neuro, GI/GU

Cardiology orders integrilin drip. Where can you find information re: this med?

Med is weight based with a bolus and continous gtt.Information re: Can look up in Lippincott drug guide online, white manual with drug calculations and refer to package insert.