Chest Pain in the Field (1).pptx helpful

Chest pain pre hospital management

1. Author: Wani Showket Created with Pi CHEST PAIN IN THE FIELD

2. CONTENTS 1. INTRODUCTION 3. HISTORY TAKING – MNEMONIC 5. RED FLAGS (IMMEDIATE TRANSPORT) 7. PREHOSPITAL MANAGEMENT – ACS FOCUS 9. SUMMARY 2. INITIAL APPROACH 4. ASSOCIATED SYMPTOMS 6. POSSIBLE LIFE-THREATENING CAUSES 8. PREHOSPITAL MANAGEMENT – OTHER CONSIDERATIONS

3. 01 INTRODUCTION

4. INTRODUCTION Chest pain = time-sensitive emergency. Possible causes: cardiac, respiratory, GI, musculoskeletal. Goal: Identify life threats early & initiate management before hospital.

5. 02 INITIAL APPROACH

6. INITIAL APPROACH Scene safety Primary survey (ABC) – airway, breathing, circulation Apply O₂ if hypoxic (<94%) Vital signs baseline before full history

7. 03 HISTORY TAKING – MNEMONIC

8. HISTORY TAKING – MNEMONIC OPQRST for pain:

9. ONSET Sudden or gradual?

10. PROVOCATION/PALLIATION What worsens/relieves?

11. QUALITY Crushing, stabbing, burning?

12. RADIATION Jaw, arm, back?

13. SEVERITY 0–10 scale

14. TIME Duration & progression Relevant medical history: cardiac risk factors, meds, allergies.

15. 04 ASSOCIATED SYMPTOMS

16. ASSOCIATED SYMPTOMS Shortness of breath Dizziness or syncope Sweating Palpitations Nausea/vomiting

17. 05 RED FLAGS (IMMEDIATE TRANSPORT)

18. RED FLAGS (IMMEDIATE TRANSPORT) Persistent or worsening pain >20 min Hypotension (<90 mmHg systolic) Severe shortness of breath Signs of shock Pain radiating to arm/jaw/back Altered mental status Cyanosis

19. 06 POSSIBLE LIFE-THREATENING CAUSES

20. POSSIBLE LIFE-THREATENING CAUSES Acute Coronary Syndrome (ACS) Aortic dissection Pulmonary embolism Cardiac tamponade Tension pneumothorax

21. 07 PREHOSPITAL MANAGEMENT – ACS FOCUS

22. PREHOSPITAL MANAGEMENT – ACS FOCUS Oxygen if SpO₂ <94% Monitor ECG if available Aspirin 160–325 mg (if no allergy or bleeding risk) Prepare for CPR/defibrillation if needed GTN (Nitroglycerin) if SBP >100 mmHg, no RV infarct, no recent PDE-5 use

23. 08 PREHOSPITAL MANAGEMENT – OTHER CONSIDERATIONS

24. PREHOSPITAL MANAGEMENT – OTHER CONSIDERATIONS Pain control as per protocol Position: semi-sitting for comfort (unless hypotensive) Avoid unnecessary movement in suspected cardiac cases Continuous monitoring & reassessment

25. 09 SUMMARY

26. SUMMARY Rapid history taking + recognition of red flags is critical. Early interventions can save lives. Always treat chest pain as cardiac until proven otherwise. Safe, prompt transport is part of the treatment.

27. THANK YOU