DRABCDE MI/ heart attack/ACS

Question 1

58 year old man that is complaining of severe central chest pain radiating to the left hand side

Answer 1

wash hands
Danger
response - fully responsive and in pain

ask for OBS -
HR 90 BP 108/70 RR 24 sats 92 on room air

meets the PERT/ MET criteria so call for help.

Question 2

assess airway

Answer 2

look, feel listen

talking freely, clutching chest and complaining of pain.

Question 3

assess breathing

Answer 3

look feel listen measure treat repeat

pale and clammy, chest movement normal
both sides and back - normal
… rest as known , sats 92 rr 24

high flow O2, maybe ABG and CXR, REASSESS!!

Question 4

assess circulation

Answer 4

pale clammy distressed JVP normal
no ankle swelling no obvious bleeding.
heart sounds normal 
cool to the touch
pulse 90 and regular. jobs as covered or normal

2 wise bore cannulae. FBC, UandE, cardiac enzymes

give - MONA
ask for ECG and reassess.

Question 5

assess disability and E

Answer 5

AVPU and BM

nil seen on top to toe

Question 6

end

Answer 6

SBAR handover
do not leave patient
look at notes and PMH and write in notes
reassure patient and organise urgent cardiology review