doubt in management - faithfullyhopeful

[ArchivalUser]

ccs!!

pt comes to the er with chest pain radiating to jaw and back. i went to the order sheet and ordered stat. oxy, iva, cardiac monitoring and vitals monitoring. then did a focused physical exam, so, how long should we wait to give ASA, as part of MONA. like till after the ecg comes back or before??

[ArchivalUser]

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[ArchivalUser]

You don't wait... give aspirin immediatly. If you wait and he does have MI then condition can get worse.
if he doesn't have MI and you give aspirin it;s not going to hurt him.

[ArchivalUser]

any chest pain patient..regardless of what the diagnosis may be down the line .. your initial orders should be the same:

(all stat)
- pulse ox, oxygen, cardiac and bp monitoring, vitals monitoring + MONA

after this, proceed to focused exam and the rest of the case.

[ArchivalUser]

iva as well

[ArchivalUser]

thanks doctam3 and wannabdr !!

i was confused about giving aspirin and the case turns out to be a dissection case requiring surgery.
thanks for clearing that!!

[ArchivalUser]

@faithfullyhopeful...
Pls don't just give aspirin and nitroglycerin to everyone with chest pain.
Look at the HPI ,they will always characterize the pain; for eg when the pain has any of these; positional , pleuritic , sharp, radiates to back in a 40 yr old lady, this pretty much place MI low on your differential