ETHOS

Having stabbing chest pains and recently took a long car trip.

Patient

Hi, I've been experiencing some pretty concerning symptoms, and I was hoping you could offer some advice.

Triage Assistant

Sure, I can help with that. Can you please describe where it hurts?

Patient

Yes, it's mainly my chest that's bothering me.

Triage Assistant

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

Patient

No, it seems pretty localized to my chest.

Triage Assistant

When did the chest pain begin?

Patient

It started a few hours ago, and it's been on and off since then.

Triage Assistant

Does the pain get worse with exertion or is it constant regardless of activity?

Patient

It's pretty much the same whether I'm active or resting.

Triage Assistant

How long does the pain last when it comes? Seconds, minutes, hours?

Patient

It's usually just for a few seconds at a time.

Triage Assistant

On a scale of 1 to 10, how bad is the pain when it happens? For reference: - MILD (1-3): doesn't interfere with normal activities - MODERATE (4-7): interferes with normal activities or awakens from sleep - SEVERE (8-10): excruciating pain, unable to do any normal activities

Patient

I'd say it's about a 6 or 7 when it strikes. It's definitely hard to ignore.

Triage Assistant

Do you have any history of heart problems or risk factors for heart disease, such as diabetes, high blood pressure, high cholesterol, smoking, or a strong family history of heart disease?

Patient

I don't have a history of heart problems or any of those risk factors, but I am kind of worried because of how intense the pain is.

Triage Assistant

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

Patient

No, I don't have any known lung issues, and I'm not on any birth control pills.

Triage Assistant

Given that your pain is moderate to severe and you've experienced it on and off for a few hours, you should seek an evaluation promptly. It is important to rule out any serious causes. Please go to the emergency department now for a thorough assessment. For now, try to stay calm and avoid exertion. If you notice any other symptoms like severe difficulty breathing, sweating, or if you feel like you might faint, lie down with your feet elevated and call 911 immediately. 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 Go to ED Now.

  • Incomplete first aid advice given.

  • Some assessment questions asked.