You are working as a Technician covering an RRV when you are called to a 45-year-old male who is experiencing chest pain. Paramedic back up is 15 minutes away. You arrive at scene and are greeted by the patients’ wife. You are shown into the living room where the patient is sat on the sofa. The patient looks very pale and sweaty. The scene is safe to approach.
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You introduce yourself and begin your assessment of the patient. You learn that the pain started gradually over minutes and has been present for the past half hour. The patient is normally fit and well with no known medical complaints. He admits to being a heavy smoker and also has never had a very good diet. You quickly work through your primary survey. What mnemonic can be used for assessing pain
Completing SOCRATES, you learn the pain is in the centre of his chest, it started when he was sat down, it is a heavy pain in nature, it radiates down his left arm, he’s felt nauseated with it, he’s had pain for about half an hour, nothing exacerbates or eases the pain, and he rates it 7 out of 10. You start taking observations, O2 sats 98%, respirations of 22, heart rate of 103, BP 107/68, temp of 35.8⁰c, blood sugars of 5.9. Your 3 lead ECG looks like a normal sinus rhythm. What medication can you give for chest pain which has an antiplatelet action
For Aspirin what is the dosage amount for an adult
You check the patient has no contra-indications and administer aspirin. Given the observations you noted, what further medication could you give to relieve coronary symptoms
What effect does GTN have
What is the dosage of GTN
You check there are no contra-indications and administer the GTN. What further medication can you consider to aid in this scenario
You give the patient some Entonox to see if it helps ease the pain. You begin to do another set of observations and paperwork.
The patient then begins to have a funny turn, and his pain becomes more intense. You note on the 3-lead screen that the T-waves are much more elevated. What may be a good idea as a pre-emptive measure if you suspect a patient is having an MI
The patient starts turning paler as you attach the pads to his chest. You try to reassure him that the Ambulance won’t be long, but with that, he becomes unresponsive and collapses on the sofa. You pull him onto the floor and feel for pulse and breathing but they are absent. What action do you take next
The defibrillator quickly analyses and advises a shock. You charge it up and defibrillate. With the shock the comes round in a dazed state. You hear the Ambulance pulling up outside. Following the patients’ change in condition what should you reassess