Thanks Mike,
Perhaps I should have been a little bit more specific in my question.
I'm aware of the process that most people go through to ask the history.
What I am most interested in is the approach to the patient who, after
initial clinical assessment *possibly* and perhaps not probably has
ischaemic chest pain, and the various protocols / pathways that are then
undertaken, which will range from just sending them home in some cases if
it's considered very low risk to a range of other alternatives.
I'm most interested in hearing from people who reckon they have a good
system in place, and hearing what it took to get that system in terms of
agreements / funding / resources etc.
PB
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Mike Bjarkoy
Sent: Wednesday, 28 March 2007 3:59 PM
To: [log in to unmask]
Subject: Re: Assessment of possibly ischaemic chest pain
Beyond the ECG interpretation and blood gas analysis, most clinicians I have
seen in the ED tend to go for the standard PQRST approach to assessment of
the patients perception of their ischaemic chest pain.
P = Provoked. What activity brought about or preceded the episode?
Q = Quality. Describe the pain--for example, crushing, stabbing, or burning.
R = Region/Radiation. Where did the sensation begin and where does the
discomfort radiate to? unordered List Item Three
S = Severity. Rate the pain on a 1-to-10 scale, with 1 being the least
painful and 10 being the most painful.
T = Timing. Describe the duration of the pain and what time of day the
symptoms began.
I'm afraid that's not very inspiring.
Mike
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Dr Paul Bailey
Sent: 28 March 2007 08:47
To: [log in to unmask]
Subject: Assessment of possibly ischaemic chest pain
Hi all,
I have a question for those of you who have spent some time thinking about
the assessment of patients with possibly ischaemic chest pain.
Do any of you out there think you do it well in your own departments? I
think it's done pretty poorly in mine..... And am looking for some
inspiration.
Kind regards
Dr Paul M Bailey MB BS PhD FACEM
Senior Lecturer in Emergency Medicine
The University of Western Australia
Emergency Physician and Deputy Director
Joondalup Health Campus
Shenton Ave
Joondalup 6027
Western Australia
Phone: + 61 8 9400 6401
Fax: + 61 8 9400 9065
Mobile: 0412 277 514
Email: [log in to unmask]
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