CPP023 Acute Coronary Syndrome - Cardiac chest pain

Question 1

Acute coronary syndrome

What should lead NEPT crew to suspect ACS and manage accordingly?

Answer 1

The presence of suspicious acute central chest pain or epigastric pain which cannot be explained by other definitive diagnosis.

Question 2

Acute coronary syndrome

Symptoms that should lead NEPT to suspect ACS.

Answer 2

a) Nausea + vomitng,
b) ECG abnormalities,
c) Pain radiating to jaw or back,
d) Pain in chest or epigastric region that is described as aching, pressure, tightness or burning,
e) Dysponea (SOB),
f) Diaphoresis (excessive sweating due to an underlying health condition or a medication).

Question 3

Acute Coronary Syndrome

What is the goal of NEPT mgmt of ACS
(4 points)

Answer 3

a) Reduce platelet aggregation (aspirin),
b) Rapid clinical escalation,
c) Reduce mycardial workload by reducing HTN (GTN),
d) Mgmt of pain (Methoxy).

Question 4

Acute Coronary Syndrome

Removal of pain in setting of ACS

Answer 4

Complete removal of pain is unlikely.
The aim of analgesia is to provide pain relief which pt considers mild.

Question 5

Acute Coronary Syndrome

Management of ACS can be broken into 5 steps

Answer 5

a) Establish ACS likelihood based on pt symptoms,
b) Escalate care per CPP006 - Aquire 12 lead if possible,
c) Administer anti-platelet aggregate (300mg Aspirin),
d) Administer anti-hypertensive (GTN),
e) Manage pain per CPP028 pain relief.

Question 6

Acute Coronary Syndrome

Explain administration of anti-hypertensive (GTN)

Answer 6

a) 0.3mg GTN S/L if SBP>100mmHg,
b) Repeat dose at 5min, consider pt pain & side effects.