ETHOS

I have chest pain and my cough is producing blood.

Patient

Hi, I'm having some health concerns and I'm really worried. Can you help me figure out what's going on?

Triage Assistant

Sure, I can help with that. Where does it hurt?

Patient

It's mostly in my chest.

Triage Assistant

Does the pain go anywhere else, like into your neck, jaw, arms, or back?

Patient

No, it's primarily in my chest.

Triage Assistant

When did the chest pain begin? Is it a matter of minutes, hours, or days?

Patient

It started a few days ago.

Triage Assistant

Does the pain come and go, or has it been constant since it started? Does it get worse with exertion?

Patient

The pain comes and goes, but it can get worse when I'm active.

Triage Assistant

How long does the pain usually last when it comes? Is it seconds, minutes, or hours?

Patient

It lasts for a few minutes each time.

Triage Assistant

How would you rate the pain on a scale of 1 to 10, where 1 is mild and doesn't interfere with normal activities, 4-7 is moderate and interferes with your normal activities or awakens you from sleep, and 8-10 is severe and excruciating pain that makes it impossible to do any normal activities?

Patient

I'd say it's about a 6 or 7. It's pretty uncomfortable and interferes with what I'm doing.

Triage Assistant

Do you have any history of heart problems or risk factors for heart disease? This includes angina, prior heart attack, diabetes, high blood pressure, high cholesterol, smoking, or a strong family history of heart disease?

Patient

I don't have any previous heart problems that I'm aware of, and I don't have high blood pressure or diabetes, but my cholesterol is a bit high, and my father had a heart attack a few years ago. I used to smoke but quit last year.

Triage Assistant

Do you have any history of lung disease, such as blood clots in the lung, asthma, or emphysema? Do you take birth control pills?

Patient

I don't have any known lung diseases, and I'm not on birth control.

Triage Assistant

What do you think is causing the chest pain? Do you have any other symptoms like dizziness, nausea, vomiting, sweating, fever, difficulty breathing, or cough?

Patient

I've been experiencing a cough lately, and sometimes it brings up a little blood, but I haven't had dizziness, nausea, vomiting, fever, or sweating.

Triage Assistant

Given the duration and description of your symptoms, including the cough with blood and the severity of your chest pain, it is strongly advised that you seek medical attention immediately. Go to the Emergency Department (ED) as soon as possible for further evaluation and treatment. If the symptoms worsen or you develop severe difficulty breathing, call 911. Thank you for calling, goodbye.

Dispositions

  • Call EMS 911 Now

  • See More Appropriate Protocol

  • Go to ED Now

  • Go to ED/UCC Now (or to Office With PCP Approval)

  • Callback by PCP Within 1 Hour

  • See in Office Today

  • Home Care

  • Triage result was accurate.

  • Incomplete first aid advice given.

  • Some assessment questions asked.