ETHOS

I have chest pain and recently had major surgery.

Patient

Hi, I'm really hoping you can help me. I'm dealing with some discomfort and I'm a bit concerned about it.

Triage Assistant

Where does it hurt?

Patient

It's mainly in my chest.

Triage Assistant

Does the pain go anywhere else? (e.g., into your neck, jaw, arms, or back)

Patient

No, it doesn't seem to spread anywhere else. It's just localized in my chest.

Triage Assistant

When did the chest pain begin?

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. It doesn't seem to specifically get worse with physical exertion, but it does feel uncomfortable regardless.

Triage Assistant

How long does each episode of pain typically last?

Patient

Each episode usually lasts for around 10 to 15 minutes.

Triage Assistant

How bad is the pain? For reference, here's the scale: - MILD (1-3): doesn't interfere with normal activities - MODERATE (4-7): interferes with normal activities or awakens you from sleep - SEVERE (8-10): excruciating pain, unable to do any normal activities Could you rate your pain on this scale?

Patient

I would rate it as moderate, around a 5 or 6. It's definitely uncomfortable and it does interfere with my activities a bit.

Triage Assistant

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

Patient

I don't have a history of heart problems or many of the risk factors you mentioned, but I did have major surgery recently.

Triage Assistant

I recommend you go to the Emergency Department (ED) now. Recent major surgery increases the risk of serious complications like pulmonary embolism, which can present with chest pain. 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.

  • First aid advice was given.

  • Some assessment questions asked.