Advanced Life Support (ALS) Level 3 (VTQ)

117 videos, 6 hours and 42 minutes

Course Content

Non-traumatic chest pain

Video 56 of 117
3 min 3 sec
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Managing Non-Traumatic Chest Pain

Step 1: Initial Response

Bringing a Defibrillator and Ensuring Patient Safety

  • Immediate Defibrillator: Carry a defibrillator to patients displaying potential heart attack symptoms and stay with them until hospital staff takes over.

Step 2: Patient Assessment

Evaluating Vital Signs and Identifying Red Flags

  • Vital Signs Assessment: Check the patient's vital signs.
  • Red Flag Criteria: If any major issues or the following red flags are present:
  • ST-Elevation Myocardial Infarction (STEMI)
  • Pulmonary Embolism
  • Aortic Dissection
  • Pneumonia
  • Respiratory Rate Less Than 10 or Over 30 Breaths per Minute
  • Oxygen Saturation (SpO2) Less Than 94% on Room Air

Step 3: Cardiac Assessment

Determining if Chest Pain May Be Cardiac

  • Chest Pain Evaluation: Assess characteristics such as location, duration, radiation, and aggravating or alleviating factors.
  • Patient History: Inquire about any history of coronary heart disease.

Step 4: Additional Symptoms

Noting Associated Features and Possible Causes

  • Accompanying Symptoms: Observe for nausea, vomiting, sweating, pallor, and cough.
  • Consider Breathlessness: If breathlessness is present as the predominant symptom, explore other potential causes.

Step 5: Clinical Assessment

Evaluating Hemodynamic Status and Identifying Non-Coronary Causes

  • Hemodynamic Problems: Check for heart failure, cardiogenic shock, or non-coronary issues, e.g., aortic dissection.
  • Rule Out Other Conditions: If ACS is unlikely based on clinical examination and a 12-lead ECG, consider alternative acute conditions like pulmonary embolism or pneumonia.

Step 6: Monitoring

Continuous Monitoring and Diagnostic Tests

  • Measure Vital Signs: Record pulse, respiratory rate, and blood pressure.
  • Arrhythmia Assessment: Use an ECG to monitor for arrhythmias.
  • ECG Transmission: If available, transmit the ECG to the hospital following local protocols.
  • Oxygen Saturation: Assess oxygen saturation and provide oxygen only if SpO2 is below 94% on room air.
  • Pain Assessment: Evaluate the patient's pain, measure the pain score, and consider providing analgesia.
  • Documentation: Complete all necessary documentation.