Round 3 (Chest Pain)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











An ill appearing patient has been rushed back from the lobby, clutching his chest, you are needed immediately at the bedside…











Initial Vitals











* Temp 99.1* HR 95* RR 20* BP 120/80* O2 98%











Courtesy of LITFL Medical Blog https://creativecommons.org/licenses/by-nc-sa/4.0/











Critical Actions











* Obtain Early EKG* Notify Cardiology of Inferior STEMI* Bring Crash Cart to Bedside* Administration of Heparin* Counsel the Family











Dangerous Actions











* Giving Nitroglycerine to Patient with Inferior MI and on Sildenafil* Giving Aspirin to Patient with Allergy to Aspirin











Final Diagnosis











Cardiac Arrest due to Inferior STEMI











Tips and Tricks











Ask about allergies prior to administering medications











Additional Reading











* Approach to STEMI (EM Clerkship)* American Heart Association STEMI Guidelines (AHA)