ANGINA AND MI

Question 1

what are the presenting signs and symptoms of an angina/mi attack?

Answer 1

Usually starts with a CRUSHING CENTRAL CHEST PAIN, radiating down the LEFT ARM, NECK and JAW

Question 2

describe the ABCDE management of an angina/MI attack

Answer 2

A - usually PATENT but potential for WHEEZING sounds
B - INCREASED RR, DECREASED Sp02(blood oxygen level), RAPID
C - HR is INCREASED or DECREASED, BP is INCREASED or DECREASED Capillary Refill Time (CRT), pt may look pale (pallor)
D - ACVPU scale - a bit anxious, glucose n/a in this situation
E - Clammy, grey in colour, sweaty, nauseous, potential evidence of cyanosis

Question 3

What is the management of Angina/MI (4)

Answer 3

• give pt OXYGEN - 15ltrs/min
• Administer GTN spray 200mcg, SUBLINGUALLY and repeat this after 3 MINS. If pain remains and if symptoms alleviate then this is an ANGINA ATTACK
• If pain worsens/remains then phone 999 and administer 300mg of DISPERSIBLE aspirin (chewed and swallowed ASAP) as this is likely an MI (heart attack)
• monitor and reassure pt until ambulance arrives - remember the SBAR handover

Question 4

what does SBAR stand for

Answer 4

S - situation
B - background
A - assessment
R - recommendations