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)