Round 30 (Chest Pain)

You are working a shift at Clerkship General Hospital when you go see your next patient, a 70 year old male presenting with chest pain.











Initial Vitals











* Temp 98.7* HR 140* RR 20* BP 125/85* O2 99%











Critical Actions











* Obtain EKG* Treat AFib RVR via rate control (and not cardioversion)* Diagnose Acute Arterial Occlusion* Treat with Heparin* Consult Vascular Surgery for further management (possible thrombectomy, bypass, etc)











Further Reading:











EMDocs – Acute Limb Ischemia











EMDocs – Systematic Approach to the Peripheral Vascular Exam