You are doing a volunteer shift as a Community First Responder in your local area when you are called to a 68-year-old with chest pain. You grab your equipment and respond to the local address. On arrival at the scene, you are invited in by the patient’s wife. You see the patient sat on the sofa in a tripod position, clutching at his chest. He is very pale and sweating profusely.
You ask for the history of events, the patient explains 20 minutes ago he was sitting down watching TV when he suddenly had pain developing down his left arm. It began to settle, then a crushing pain started in his chest. The pain has grown and he now can’t bear it anymore.
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You start assessing the patient, there’s no obvious bleeding, and his airway is clear. You note he is breathing quickly at around 24 breaths per minute, and you place your SPO2 monitor on his finger. The reading comes back as 87%. The patient has no other relevant medical history, what should a normal SPO2 range in an adult be
What treatment are you able to give to help manage this
You apply oxygen via facemask to the patient. Following a few initial breaths, his breathing calms down. You continue with his assessment, you find his pulse is elevated at 110 beats per minute, he is cold and clammy to touch, and has a temperature of 36.2°C.
You conduct a central capillary refill time and it comes back in 3 seconds. For a healthy normal adult, what length of time should it be less than
Having reviewed everything, you know the patient isn’t in a good way. You ask again over the symptoms and history, what mnemonic can be used to help assess pain
You now have a detailed history of the pain and symptoms. With central chest pain, 8/10, crushing in nature, radiating down the left arm, being constant for the last 30 minutes, and associated symptoms of sweating and paleness, what is your main impression of what is happening
You feel reviewing the symptoms that the patient is having a myocardial infarction, a heart attack. Your responder phone rings, and it is a control Paramedic on the line. The Paramedic explains that the ambulance is 15 minutes away. She asks what the patient is like and if you have any observations. You give a handover of the events and all the signs and symptoms you’ve observed. You mention you feel the patient is having a heart attack, and the Paramedic agrees it sounds like it. She asks if the patient has any medication for chest pain, and the patient says he doesn’t. What household medication can sometimes be advised over the phone by ambulance call staff if a patient calls with chest pain
The Paramedic asks if the patient has taken any Aspirin, which he says no. The wife mentions there is some in the house and brings it to him. Under instruction from the Paramedic, the wife gives the patient Aspirin. She asks you to continue to monitor the patient and will chase up the Ambulance back-up.
As you are on the phone the patient says he doesn’t feel well and collapses unconscious on the sofa. You explain to the Paramedic and go to check him over. His airway is clear, but he isn’t breathing and doesn’t have a pulse. You pull him to the floor. What should be your first action
You put on the defibrillator pads and set the AED to work. It advises a shock. You defibrillate the patient and immediately he starts breathing again. He starts to cough but remains in an unconscious state. You check the airway, and confirm he is breathing and has a pulse. What position can you place him in until help arrives
You hear sirens coming up the street and a knock at the door. 2 Paramedics enter and start assisting you. You give a handover of the events. Which of the following occurred