Case Study - Chest Pain
Scene: You are racing in a ski marathon in the upper peninsula of Michigan. You are lightly dressed and are carrying only a .5L water bottle and one energy gel. The closest aid station is eight kilometers away. Medical support is available at the finish line.
Weather: Ambient temperature is 5º F with light snow.
Patient Presentation: Eight kilometers into the race you encounter a man in his mid-sixties who has stepped to the side of the trail. He is holding his shoulder and grimacing. You ask if he is okay and he tells you that he “tweaked his shoulder”. He tells you he is experiencing pain in his left shoulder, neck and the left side of his chest.
Initial Assessment: The patient has a clear airway and both respiration and circulation are intact. He denies having fallen or losing consciousness.
Focused Assessment:
Vitals
At 0915: HR 152 (radial); RR 22. SCTM is pale and sweaty. LOR is AO x 4. You notice that he seems anxious.
SAMPLE
The patient complains of a crushing pain in his left shoulder, neck and left side of his chest. He reports the pain is a seven of ten
on a pain scale. The pain began ten minutes ago and increased as he skied. He also reports feeling slightly nauseated. The patient
reports no allergies. He takes one aspirin daily. He reports that he has not experienced anything like this before.
Physical Exam
The patient states that he has not experienced a trauma and you choose not to complete a physical exam due to environmental
conditions.
What’s next?
Identify current problems, anticipated problems and create a plan of action of what you would do for the skier. Once you have created the lists and plans, click the "Continue" button below to check your answers and compare your plans
Weather: Ambient temperature is 5º F with light snow.
Patient Presentation: Eight kilometers into the race you encounter a man in his mid-sixties who has stepped to the side of the trail. He is holding his shoulder and grimacing. You ask if he is okay and he tells you that he “tweaked his shoulder”. He tells you he is experiencing pain in his left shoulder, neck and the left side of his chest.
Initial Assessment: The patient has a clear airway and both respiration and circulation are intact. He denies having fallen or losing consciousness.
Focused Assessment:
Vitals
At 0915: HR 152 (radial); RR 22. SCTM is pale and sweaty. LOR is AO x 4. You notice that he seems anxious.
SAMPLE
The patient complains of a crushing pain in his left shoulder, neck and left side of his chest. He reports the pain is a seven of ten
on a pain scale. The pain began ten minutes ago and increased as he skied. He also reports feeling slightly nauseated. The patient
reports no allergies. He takes one aspirin daily. He reports that he has not experienced anything like this before.
Physical Exam
The patient states that he has not experienced a trauma and you choose not to complete a physical exam due to environmental
conditions.
What’s next?
Identify current problems, anticipated problems and create a plan of action of what you would do for the skier. Once you have created the lists and plans, click the "Continue" button below to check your answers and compare your plans
