How do you assess a patient with chest pain?

Perform a 12-lead ECG and have it checked by a medical officer as soon as possible. Performing and interpreting a 12-lead ECG is a vital assessment in the setting of chest pain. An ECG will help the medical team determine if and when a patient requires reperfusion therapy to treat the cause of the chest pain.

Which descriptions of chest pain would be associated with ACS?

The signs and symptoms of acute coronary syndrome usually begin abruptly. They include: Chest pain (angina) or discomfort, often described as aching, pressure, tightness or burning. Pain spreading from the chest to the shoulders, arms, upper abdomen, back, neck or jaw.

What tests are ordered to diagnose patients with acute coronary syndrome?

Tests include:

• Electrocardiogram (ECG). Electrodes attached to your skin measure the electrical activity in your heart.
• Blood tests. Certain enzymes may be detected in the blood if cell death has resulted in damage to heart tissue.

Which of the following is the drug of choice for managing chest pain in ACS?

Chest pain is the most common symptom of patients who present with ischemic heart disease. Morphine has traditionally been the drug of choice for managing chest pain in acute coronary syndrome (ACS) due to its high analgesic potency, though its physiological effects are poorly understood.

What is the triage category for chest pain?

Emergency (triage category 2) is for conditions that could be life threatening and require prompt attention such as chest pain or possible stroke. Patients in this category should be seen within 10 minutes of presenting to the emergency department.

How do you manage chest pain in emergency?

If you or someone else may be having a heart attack, follow these first-aid steps:

1. Call 911 or emergency medical assistance.
2. Chew aspirin.
3. Take nitroglycerin, if prescribed.
4. Begin CPR on the person having a heart attack.

What is the initial drug therapy for ACS?

Morphine (or fentanyl) for pain control, oxygen, sublingual or intravenous (IV) nitroglycerin, soluble aspirin 162-325 mg, and clopidogrel with a 300- to 600-mg loading dose are given as initial treatment.

What is pathophysiology of ACS?

Pathophysiology. The underlying pathophysiology in ACS is decreased blood flow to part of heart musculature which is usually secondary to plaque rupture and formation of thrombus. Sometimes ACS can be secondary to vasospasm with or without underlying atherosclerosis.

What Diagnostics & Labs are important in identifying ACS?

By performing an electrocardiogram (ECG) and measuring for a biomarker of cardiac necrosis (cardiac troponin), clinicians can make a diagnosis of ACS, and furthermore distinguish the disease into three categories: unstable angina (UA), non-ST-segment elevation MI (NSTEMI), and ST-segment elevation MI (STEMI).

What is the difference between ACS and MI?

Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or heart attack (myocardial infarction), depending on the location and amount of blockage. A heart attack is death of heart tissue due to lack of blood supply.

What is the priority of care for a patient diagnosed with ACS?

General priorities for patients with ACS are haemodynamic monitoring and close observation of vital signs. A review of fluid status can provide information about renal perfusion, as some patients may present with, or develop, heart failure.

What is recommended indicated to be administered to ACS patients?

In all patients with possible ACS and without contraindications, aspirin (300 mg orally) should be given as soon as possible after presentation.

What are the best practices for improving triage in cardiac care?

For implementation best practices: One of the greatest impacts on triage processes has been the ability to rapidly identify patients at risk for STEMI (ST elevation myocardial infarction) and other acute coronary syndromes. Adults over 30 years of age with non-traumatic chest pain should prompt the triage nurse to consider the possibility of ACS.

What is considered a high priority triage case for acute coronary syndrome (ACS)?

All patients presenting to the ED with chest discomfort or other symptoms suggestive of ACS should be considered high-priority triage cases. Evaluation and treatment should follow a predetermined, institution-specific protocol for chest pain.

What is the role of the triage nurse in chest pain?

When a patient presents with chest pain or chest-related symptoms, the role of the triage nurse is to critically evaluate the relationship of risk factors to outcome potentials to make the best triage decisions. The more risk factors a patient has, the greater the triage nurse’s concern for a potential high-risk scenario.

What to consider when triageing a patient with chest pain/dyspnea?

While recognizing risk factors in the presenting patient with chest pain/dyspnea, the triage nurse must also consider the following: 1 Absence of chest pain does not imply absence of a cardiac event. 2 Not all patients present with classic or typical signs/symptom – especially the elderly, diabetic or female patient. 3 Don’t delay obtaining an ECG.