Non Traumatic Chest Pain

Question 1

What are some of the differentials of non-traumatic chest discomfort? (12)

Answer 1

trauma vs. medical, angina vs. MI, pericarditis, mitral valve prolapse, pulmonary embolism, asthma/COPD, pneumothorax, aortic aneurysm, GI reflux, hiatal hernia, esophageal spasm, chest wall injury, pleural pain

Question 2

What is the EMT-B Protocol for non traumatic chest pain?

Answer 2

General Impression, ABC, oxygen, administer 324 mg of aspirin, obtain 12 lead

Question 3

What is the Paramedic portion of this protocol?

Answer 3

All EMT-B part, cardiac monitor, 12 lead interpretation, establish IV at KVO or saline lock, consider administration of Fentanyl, transport.

Question 4

What is the dosage of Fentanyl?

Answer 4

1-3mcg / kg slow IVP

Question 5

When can you give Fentanyl? (Vital sign)

Answer 5

If systolic BP is above 90 mmHg

Question 6

How often can Fentanyl be given?

Answer 6

Every 20 to 30 minutes

Question 7

What do you do if chest pain is suspected due to cocaine toxicity?

Answer 7

If 12 lead does not indicate AMI, then you can administer Versed 2.5 to 5 mg slow via IVP. Every 20-30 minutes.

Question 8

What are the ischemic cardiac causes of chest discomfort? (6)

Answer 8

angina, AMI, aortic stenosis, hypertrophic cardiomyopathy, coronary vasospasm

Question 9

What are the non ischemic cardiac causes of chest discomfort? (3)

Answer 9

pericarditis, aortic dissection, mitral valve prolapse.

Question 10

What are the gastro causes of chest discomfort? (5)

Answer 10

gastric reflux, esophageal spasm, esophageal perforation, gastritis, peptic ulcer disease

Question 11

What are the pulmonary causes of chest discomfort? (5)

Answer 11

pneumothorax, pulmonary embolism, pleuritis, tumor, bronchitis

Question 12

Musculoskeletal causes of chest discomfort? (3)

Answer 12

costochondritis, rib fracture, shingles

Question 13

In what leads will elevation be seen in a Septal infarction?

Answer 13

V1, V2

Question 14

In what leads will reciprocal changes be seen in Septal infarction?

Answer 14

None

Question 15

In what leads will elevation be seen in an Anterior infarction?

Answer 15

V3, V4

Question 16

In what leads will reciprocal changes be seen in Anterior infarction?

Answer 16

None

Question 17

In what leads will elevation be seen in an Anterior-Septal infarction?

Answer 17

V1, V2, V3, V4

Question 18

In what leads will reciprocal changes be seen in an Anterior-Septal infarction?

Answer 18

None

Question 19

In what leads will elevation be seen in a Lateral infarction?

Answer 19

1, aVL, V5, V6

Question 20

In what leads will reciprocal changes be seen in a Lateral infarction?

Answer 20

II, III, avF

Question 21

In what leads will elevation be seen in an antero-lateral infarction?

Answer 21

1, aVL, V3, V4, V5, V6

Question 22

In what leads will reciprocal changes be seen in a antero-lateral infarction?

Answer 22

II, III, avF

Question 23

In what leads will elevation be seen in a Inferior infarction?

Answer 23

II, III, avF

Question 24

In what leads will reciprocal changes be seen in a inferior infarction?

Answer 24

I, aVL

Question 25

In what leads will elevation changes be seen in a infero-lateral infarction?

Answer 25

II, III, aVF, V5, V6

Question 26

In what leads will reciprocal changes be seen in a infero-lateral infarction?

Answer 26

I, aVL, V1, V2

Question 27

In what leads will elevation be shown in a posterior infarction?

Answer 27

None

Question 28

In what leads will reciprocal changes be shown in a posterior infarction?

Answer 28

V1, V2, V3, V4