ETHOS

Experiencing chest pain with nausea and significant family history of heart disease.

Patient

Hi, I've been feeling pretty unwell lately and I'm really concerned. I'm not sure if it's something serious, but I wanted to get some advice.

Triage Assistant

I'm here to help. Could you please tell me where it hurts?

Patient

Sure, it's my chest that's been hurting a lot.

Triage Assistant

I need to ask you a few questions to better understand your condition. Does the pain go anywhere else, like into your neck, jaw, arms, or back?

Patient

No, it doesn't really move around. It just stays in my chest.

Triage Assistant

When did the chest pain begin?

Patient

It started a couple of days ago, but it's been getting progressively worse.

Triage Assistant

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

Patient

It comes and goes, but it's definitely worse when I'm moving around or doing any kind of physical activity.

Triage Assistant

How long does each episode of pain last (e.g., seconds, minutes, hours)?

Patient

Each episode probably lasts a few minutes, not usually longer than that. But it can be really intense when it does happen.

Triage Assistant

On a scale of 1 to 10, how would you rate the severity of the pain during these episodes? - MILD (1-3): does not interfere with normal activities - MODERATE (4-7): interferes with normal activities, or wakes you from sleep - SEVERE (8-10): excruciating pain, unable to perform any normal activities

Patient

I'd say it's usually around a 6 or 7; it's definitely interfering with what I can do.

Triage Assistant

Do you have any history of heart problems or risk factors for heart disease (e.g., diabetes, high blood pressure, high cholesterol, smoking, or a strong family history of heart disease)?

Patient

Yes, I have a significant family history of heart disease which is why I'm really worried about this.

Triage Assistant

Given your symptoms and significant family history of heart disease, you should seek medical attention immediately. Please go to the emergency department as soon as possible. If possible, have someone else drive you or call for emergency medical services. 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 should be Call EMS 911 Now.

  • Incomplete first aid advice given.

  • All assesssment questions asked.