Question

Simulation video.

CHRISTINE: Emergency Department, this is Christine.

WYATT: Hi, this is Wyatt, one of the emergency medical technicians. We’ll be arriving soon with a

Client, who’s experiencing chest pain. His name is Rodney Davis. He’s 54 and arriving per EMS

Transfer to the Emergency Department. His chest pains started at 16:55. His wife gave him three doses

of nitroglycerin when it started. In addition, she gave him 325 milligrams of aspirin at 17:15. He has a

peripheral IV access line, and we’re sending the EMS report to you now with vital signs and medical

history.

CHRISTINE: OK, I’ll review the report, and we’ll be ready when you get here.

CHRISTINE: Hi, Mr. Davis. I’m Christine. I’m your nurse. Are you still having chest pain or

tightness?

RODNEY: Yes. Feels like my chest is being squeezed right here. And it’s hard to breathe.

CHRISTINE: When did the discomfort start?

RODNEY: About 5:00. And it’s as intense, if not worse, and I feel dizzy, sick to my stomach.

MAGGIE: My husband takes nitroglycerin sometimes when he has chest pain, but this time, the pain

Just hasn’t gone away. And he does have a history of blocked arteries.

CHRISTINE: OK. I’m going to switch these lead wires to our to monitor your heart rate rhythm

While you’re here. So what were you doing when the pain started?

RODNEY: I was outside shoveling my driveway.

CHRISTINE: On a scale of zero to 10, with 10 being the highest level of pain, what are you feeling?

RODNEY: With this squeezing over my heart, I’d say an eight.

CHRISTINE: OK. The electrocardiogram tech is coming to perform a 12 lead ECG, which will help

determine if your in pain is it due to a heart attack. Then the provider will review the results. I’m going to go and check up on your orders, and I’m going to come back with something for your pain.

1-Share one clinical experience that remind you of this scenario

Answer 1

I do remember an incident while I was working with an ER nurse, a patient had reported with a shrapnel wound. First, we got a call from the emergency medical technician, reporting about the incident and the arrival of the patient via EMS. He was a 45-year-old gentleman with the shrapnel stuck on his right shoulder. The patient was bleeding profusely from the wound and was in severe pain. He stated a pain of 10 on a scale of zero to 10. He was accompanied by his friend who was with him while the incident happened. He appeared very weak and was started on IV fluids. The wound was appropriately dressed with gauze by the EMT, which was removed. An effort was made to control bleeding by applying direct pressure and the wound was covered with clean gauze. He was started on analgesics and sedatives and was transferred to OR for the immediate removal of shrapnel.