Flashcards in EM Basic Chest Pain Deck (16):
What is the mnemonic for 6 deadly causes of chest pain?
What is the workup for for pts w/chest pain?
EKG - screens for CAD, arrhythmia
CXR - pneumo, dissection, esophageal rupture
What gives an immediate ticket to CATH lab?
Chest pain + STE 2mm or > in 2 contiguous leads
Young thin smoker w/sudden onset of chest pain look for what?
Esophageal rupture - how to rule out?
CXR - free air under diaphragm
Peritonitis on ABD exam
Hx of forceful vomiting - alcoholic?
Dissection - how to r/o?
HTN hx, pregnancy, CT diseases
Unequal BPs (> 20)
Chest pain + motor/Neuro think of what?
What is an atypical presentation for females w/MI?
Fatigue, weak, Nausea, Diabetic
What labs to order for MI?
CBC - anemia?
Chem10 - electrolyte abnormalities
Coags - want baseline set
Cardiac enzymes - troponin elevates in first 4-6 hours, CK 6-8
R/o MI give what for treatment?
Nitroglycerin 0.4 mg sublingual q5 min x 3 doses, HOLD if systolic < 100 or no chest pain, if they pass out give them 500mL NS bolus
If still in Pain: 4 mg IV Morphine + 8mg Zofran
Repeat EKG before admit
What is the basic w/u for PE?
CXR - maybe PA lateral
Chem10 - Cr for CT
Coags - baseline needed
What is the PERC rule?
Low risk for PE, no CTA needed
Blood in sputum
RA sat < 95%
Age > 50
Thrombosis in PMHx
HR > 100
Surgery in last 4 weeks
When should you get a d-dimer?
PERC +, usually bc of HR or OCPs
How to treat PE w/no vital signs change?
If no hemodynamically unstable?
1 mg/kg Lovenox subQ or Heparin and order Cardiac enzymes, BNP
PE w/u need what?
Risk Stratify - Med/High —> Get CTA chest