Download presentation
Presentation is loading. Please wait.
1
Cardiac Differential Diagnosis
Will/Grundy EMS Continuing Education January 2011 Written by: -Laurie Carroll, RN, Advocate Bolingbrook Hospital -Will/Grundy EMS Staff
2
Differential Diagnosis of Chest Pain
There are literally dozens of illnesses, injuries and conditions that can cause chest pain. Knowing common signs, symptoms and patient presentations can help you differentiate between different kinds of chest pain. Bottom Line: If you are ever not sure what kind of chest pain you are dealing with, treat it as cardiac and call medical control.
3
Differential Diagnosis of Chest Pain
Common Causes of Chest Pain Cardiovascular: ischemia (AMI or angina) pericarditis (irritation of pericardium) thoracic aortic dissection
4
Differential Diagnosis of Chest Pain
Common Causes of Chest Pain Respiratory: PE (pulmonary embolism) pneumothorax pneumonia pleural irritation hyperventilation (anxiety)
5
Differential Diagnosis of Chest Pain
Common Causes of Chest Pain Gastrointestinal: cholecystitis (gall bladder/gallstones) pancreatitis hiatal hernia (part of stomach pushes through diaphragm) esophageal disease/GERD peptic ulcers dyspepsia (indigestion)
6
Differential Diagnosis of Chest Pain
Common Causes of Chest Pain Musculoskeletal: chest wall syndrome (inflamed chest wall) costochondritis (inflamed rib cartilage) herpes zoster (shingles) chest wall trauma chest wall tumors
7
QUESTIONS TO HELP DIFFERENTIATE CHEST PAIN
CAUSE ONSET OF PAIN CHARACTERISTIC OF PAIN LOCATION OF PAIN HISTORY ASSOCIATED SX/SX AGGRAVATING FACTORS RELIEVING FACTORS
8
DETERMINE ONSET/DURATION OF PAIN
Was it… Sudden? Gradual? Lasts Minutes? Lasts Hours? Varies?
9
“QUALITY” OF PAIN PLEURITIC (sharp pain with inhalation)
SPASMODIC (like a spasm) TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED (easy to pinpoint) VISCERAL (hard to pinpoint)/BURNING TEARING / EXCRUCIATING
10
LOCATION SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST
LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
11
HISTORY AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA
STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
12
Associated Signs/Symptoms?
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS /LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS (coughing up blood) PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
13
AGGRAVATING FACTORS? BREATHING MOVEMENT STRESS EXERTION
AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
14
RELIEVING FACTORS – What makes it feel better?
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
15
Now lets match the chest pain diagnosis with the symptoms….
The list items in red italics are the ones that go with the diagnosis….
16
ANGINA ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
17
ANGINA QUALITY PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS
PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
18
ANGINA LOCATION SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST
LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
19
ANGINA HISTORY AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER
TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
20
ANGINA ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
21
ANGINA AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
22
ANGINA RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
23
Acute Myocardial Infarction ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
24
Acute Myocardial Infarction QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
25
Acute Myocardial Infarction LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
26
Acute Myocardial Infarction HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
27
Acute Myocardial Infarction ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
28
Acute Myocardial Infarction AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
29
Acute Myocardial Infarction RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
30
Dissecting Aneurysm ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
31
Dissecting Aneurysm QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
32
Dissecting Aneurysm LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE ABDOMEN
33
Dissecting Aneurysm HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
34
Dissecting Aneurysm ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
35
Dissecting Aneurysm AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY In other words, it hurts badly no matter what.
36
Dissecting Aneurysm RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS In other words, nothing helps it feel better.
37
PERICARDITIS ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
38
PERICARDITIS QUALITY PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS
PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
39
PERICARDITIS LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST/RETROSTERNAL LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
40
PERICARDITIS HISTORY AGE PREVIOUS EPISODES
UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
41
PERICARDITIS ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS PARADOXICAL PULSE
42
PERICARDITIS AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
43
PERICARDITIS RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
44
PNEUMOTHORAX ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
45
PNEUMOTHORAX QUALITY PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS
PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
46
PNEUMOTHORAX LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
47
PNEUMOTHORAX HISTORY AGE PREVIOUS EPISODES
UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
48
PNEUMOTHORAX ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
49
PNEUMOTHORAX AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
50
PNEUMOTHORAX RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
51
PULMONARY EMBOLISM ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
52
PULMONARY EMBOLISM QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
53
PULMONARY EMBOLISM LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
54
PULMONARY EMBOLISM HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS SMOKING/RECENT SURGERY/BCP (birth control pill)
55
PULMONARY EMBOLISM ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
56
PULMONARY EMBOLISM AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
57
PULMONARY EMBOLISM RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
58
HIATAL HERNIA ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
59
HIATAL HERNIA QUALITY PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS
PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
60
HIATAL HERNIA LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
61
HIATAL HERNIA HISTORY AGE PREVIOUS EPISODES
UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
62
HIATAL HERNIA ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
63
HIATAL HERNIA AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
64
HIATAL HERNIA RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
65
GASTROINTESTINAL ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
66
GASTROINTESTINAL QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
67
GASTROINTESTINAL LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
68
GASTROINTESTINAL HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS Maybe none…. For example, food poisoning doesn’t require a history other than recent eating.
69
GASTROINTESTINAL ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
70
GASTROINTESTINAL AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
71
GASTROINTESTINAL RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
72
PNEUMONIA/PLEURISY ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
73
PNEUMONIA/PLEURISY QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING
74
PNEUMONIA/PLEURISY LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
75
PNEUMONIA/PLEURISY HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
76
PNEUMONIA/PLEURISY ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS
77
PNEUMONIA/PLEURISY AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
78
PNEUMONIA/PLEURISY RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS
79
HYPERVENTILATION/ANXIETY ONSET/DURATION OF PAIN
Sudden Gradual Lasts Minutes Lasts Hours Varies
80
HYPERVENTILATION/ANXIETY QUALITY
PLEURITIC SPASMODIC TIGHTNESS OR HEAVINESS PRESSURE- OPPRESSIVE SHARP/LOCALIZED VISCERAL/BURNING TEARING / EXCRUCIATING VAGUE/DIFFUSE
81
HYPERVENTILATION/ANXIETY LOCATION
SUBSTERNAL CENTER OR ACROSS CHEST LATERAL CHEST LOCALIZED OVER INVOLVED AREA LOWER CHEST/EPIGASTRIC RADIATES TO JAW, NECK, BACK OR ARM VAGUE
82
HYPERVENTILATION/ANXIETY HISTORY
AGE PREVIOUS EPISODES UPPER RESPIRATORY INFECTION/FEVER TRAUMA STRESS EMOTIONAL UPSET CARDIAC DISEASE – HTN, CAD, ANGINA PHLEBITIS
83
HYPERVENTILATION/ANXIETY ASSOCIATED SX / SX
DYSPNEA DIAPHORESIS NAUSEA / VOMITING AMS /WEAKNESS / LIGHTHEADEDNESS / SYNCOPE NEURO CHANGES HYPO OR HYPERTENSION OR UNEQUAL BP DECREASED OR ABNORNMAL BREATH SOUNDS CYANOSIS HEMOPTYSIS PULSATING ABD MASS ABDOMINAL PAIN VESICULAR PAIN WITH PALPATION RASH OR LESIONS INCREASED RESP RATE NUMBNESS –EXTREMITIES/FACE
84
HYPERVENTILATION/ANXIETY AGGRAVATING FACTORS
BREATHING MOVEMENT STRESS EXERTION AFTER EATING OR ETOH LAYING DOWN SITUATIONAL / ANXIETY
85
HYPERVENTILATION/ANXIETY RELIEVING FACTORS
REST OR DECREASED MOVEMENT POSITION SITTING UP OR LEANING FORWARD DECREASED OR SHALLOW BREATHING DIET ANTACIDS MEDICATIONS DECREASED ANXIETY
87
And now…. It’s time for Call Type of the Month!
88
Will/Grundy Call Type of the Month
Fall call! Not this kind…. This kind!
89
Will/Grundy Call Type of the Month
Most important thing to remember: Falling is a symptom, not a complaint. There is always a reason why they fell. Tripped Dexi Dizzy Dead Etc.
90
Will/Grundy Call Type of the Month
Fall assessment is targeted toward determining and treating associated injuries and possible causes – as well as ruling out pertinent negatives. Narratives/PCR’s need to reflect this process. This is not enough: “Called to 62yo female a&ox3 but lethargic, laying in bathroom, 1 in. lac r temple. Bleeding ctx w/4x4. Pt c/o upper back pain. Family sez they fall a lot. Pt board/collar, vitals as per below, head-to-toe, etc, etc, etc….”
91
Will/Grundy Call Type of the Month
EMS crews need to provide clues from the scene to help ER staff answer the question: Why did this patient fall? Was it sugar? Cardiac? Blood pressure? Heat? Rug needs to be taped down? Better: “Called to 62yo female a&ox3 but lethargic, laying in bathroom, 1 in. lac r temple. Bleeding ctx w/4x4. Pt c/o upper back pain. Family sez they fall a lot. Pt stated she felt dizzy as she got up from commode. Pt states she often feels dizzy in the mid-morning. Crew notes pt BP is lower than BP recorded by home CNA in am. Pt board/collar, head-to-toe, etc, etc, etc…”
92
Will/Grundy Call Type of the Month
Absolutely no idea why they fell? Well, if after a thorough assessment and treatment you have no clues to report, then stick to the pertinent negatives: Example: “Called to 62yo female a&ox3 but lethargic, laying in bathroom, 1 in. lac r temple. Bleeding ctx w/4x4. Pt c/o upper back pain. Pt states does not remember falling. Family unable to offer hx due to lang. barrier. Crew notes no obvious slip/fall hazards in bathroom. Etc, etc, etc…...”
93
Will Grundy Call Type of the Month
Summary: Many fall calls need ALS care. It’s tempting at 2am to just board, collar and transport. But there is always a reason why they fell. We are the eyes and ears of the doctor on the scene. So we need to gather clues during the assessment process.
94
Thank you!
Similar presentations
